Friday:
I saw my GP Dr Miller again today. The results for the glucose tolerance test are in, down to 8.9 mmol/L after being 10.8 last year (11.0 is diabetes). Still in the pre-diabetic zone but much better. My blood sugar diet and losing a bit of weight seem to be helping.
She has referred me to a gynaecologist about the fibroids but they can't see me until late July.
We also discussed my mood and she has referred me to a psychologist(?) who will see me in about three weeks. She seemed to think I have a tendency towards depression, exacerbated by recent major life events i.e. the deaths of both my parents and then the move to another state where I have no friends. I lean more towards the hormonal explanation and I feel a bit of a fraud in a way because I'm not really that depressed. I know what depressed is like. And I'm a lot better with anti-menopause tablets. But I am very willing to go and talk to someone about it. Can't hurt.
She also told me off for not using my CPAP.
I like this doctor, it's a shame she's only at the clinic until the end of July.
Ate well again today. I don't know how to number this anymore. It's supposed to be an eight week diet. I did eight weeks back in Jan/Feb but by the end I wasn't really sticking to it at all. I started again seven and a half weeks ago - two days left of this eight week cycle. But I had nearly a week off with the carb loading so I haven't really done eight weeks... oh bugger it whatever. I'll just keep going.
Showing posts with label prediabetes. Show all posts
Showing posts with label prediabetes. Show all posts
Friday, May 20, 2016
Wednesday, May 18, 2016
Glucose Tolerance Test
Wednesday:
I had my glucose tolerance test this morning. It involved eating high carb for three days (not everywhere requires this) then fasting for 12 hours and having blood taken, drinking a nasty glucose liquid with 75g of pure carbohydrate, then testing again two hours later. I will get the results (ie whether I am diabetic) in a couple of days. I did tests with my own kit while I was there, I peaked high (12.5 mmol/L, which is diabetic) at one hour but was back down to 10.3 mmol/L (pre-diabetic) at two hours. The official test is at the two hour point so I'm assuming I will still be considered pre-diabetic. But my testing hasn't always matched the official result when I've done this before, so we'll see. Home kits aren't as accurate as the lab.
I have been so inconsistent with "getting healthy" that I really have no idea whether to expect to be better or worse than last time.
I had lunch when I got home but around two hours after that - nearly four hours after the glucose liquid - I had a blood sugar crash. I felt very shaky and odd. I went and tested my blood and it was down to 3.9 mmol/L (70.2 mg/d) which is right on the borderline of normal to low. Certainly nothing dangerous, I wasn't about to go into a coma, but I was trembling so hard I could hardly hold the blood test pen and I felt quite unwell. I went and ate some more, including carbs, and got my blood sugar back up to normal. I'm assuming it was a reaction to the high of the test leading to a crash (reactive hypoglycaemia). I hope that isn't a bad sign. I spent the rest of the day trying to balance my food intake.
It would have been my mother's 75th birthday today. Sad thinking about her.
I had my glucose tolerance test this morning. It involved eating high carb for three days (not everywhere requires this) then fasting for 12 hours and having blood taken, drinking a nasty glucose liquid with 75g of pure carbohydrate, then testing again two hours later. I will get the results (ie whether I am diabetic) in a couple of days. I did tests with my own kit while I was there, I peaked high (12.5 mmol/L, which is diabetic) at one hour but was back down to 10.3 mmol/L (pre-diabetic) at two hours. The official test is at the two hour point so I'm assuming I will still be considered pre-diabetic. But my testing hasn't always matched the official result when I've done this before, so we'll see. Home kits aren't as accurate as the lab.
I have been so inconsistent with "getting healthy" that I really have no idea whether to expect to be better or worse than last time.
I had lunch when I got home but around two hours after that - nearly four hours after the glucose liquid - I had a blood sugar crash. I felt very shaky and odd. I went and tested my blood and it was down to 3.9 mmol/L (70.2 mg/d) which is right on the borderline of normal to low. Certainly nothing dangerous, I wasn't about to go into a coma, but I was trembling so hard I could hardly hold the blood test pen and I felt quite unwell. I went and ate some more, including carbs, and got my blood sugar back up to normal. I'm assuming it was a reaction to the high of the test leading to a crash (reactive hypoglycaemia). I hope that isn't a bad sign. I spent the rest of the day trying to balance my food intake.
It would have been my mother's 75th birthday today. Sad thinking about her.
Wednesday, October 7, 2015
Pre-diabetes and sleep apnoea
Thursday:
I've been a bit worried lately about my pre-diabetes. I ran out of test strips for my meter a while ago but I have more now; yesterday I tested my blood glucose level six times during the day after eating my usual kind of diet. Five of the numbers were bad. Ironically, the only normal one was a couple of hours after two big homemade choc chip cookies.
One of the (many) reasons I struggle to start eating healthy is that I get paralysed by choice. Should I just count calories or go low-carb or low-fat or Paleo or no-sugar or no-sugar AND no-grain or CSIRO diet or Weight Watchers or carb cycling or intermittent fasting or intuitive eating or just exercise a lot while eating whatever I like? I flip flop between wanting to make huge changes to get fast results, or baby steps to be more sustainable. Too many choices!
Well my body is telling me more and more clearly that it cannot handle "normal" amounts of carbohydrate. It's not just a matter of being overweight and all the problems that brings, every time my blood glucose spikes it is doing my body damage. Destroying beta cells in my pancreas. Damaging blood vessels. Downward spiral into diabetes.
So the choice has been made for me. Carb moderation. I am not cutting out any particular foods/quasi-foods, but I am restricting carbohydrate to one serving in each meal and snack. One piece of fruit. One potato. One slice of bread. A couple of squares of chocolate. I know that so far my blood glucose levels are totally under my control as long as I watch my carbohydrate intake.
I don't know how I can have little bursts of worry about this then slip back into apathy - or at least not caring enough to stay committed.
My other area of focus right now is my sleep apnoea. With people inspecting our home I would have had to pack up and unpack the CPAP three times a week and I just couldn't be bothered. Also I've had the flu with runny nose and sore throat and cough etc, which does not go at all well with a CPAP mask (I use nose pillows). The result is, I haven't used it for a month or so. Well my flu is better (finally) and today is the last inspection with the auction this evening. No more excuses. I'm using my CPAP every night until we move (I like short term goals). I hate wearing it, but I need it. My brain needs oxygen. And it's hard to be at my best when I'm constantly tired.
The past couple of weeks I've been saying to myself "I'm too stressed right now, I'll worry about it after we sell the house" so it might seem odd I'm talking about this today rather than tomorrow (assuming we even sell tonight). But my body is giving me very clear signals I need to deal with it now. And what am I asking of myself, after all? Eat a bit less carb, wear my CPAP. Hardly torture.
I've been a bit worried lately about my pre-diabetes. I ran out of test strips for my meter a while ago but I have more now; yesterday I tested my blood glucose level six times during the day after eating my usual kind of diet. Five of the numbers were bad. Ironically, the only normal one was a couple of hours after two big homemade choc chip cookies.
One of the (many) reasons I struggle to start eating healthy is that I get paralysed by choice. Should I just count calories or go low-carb or low-fat or Paleo or no-sugar or no-sugar AND no-grain or CSIRO diet or Weight Watchers or carb cycling or intermittent fasting or intuitive eating or just exercise a lot while eating whatever I like? I flip flop between wanting to make huge changes to get fast results, or baby steps to be more sustainable. Too many choices!
Well my body is telling me more and more clearly that it cannot handle "normal" amounts of carbohydrate. It's not just a matter of being overweight and all the problems that brings, every time my blood glucose spikes it is doing my body damage. Destroying beta cells in my pancreas. Damaging blood vessels. Downward spiral into diabetes.
So the choice has been made for me. Carb moderation. I am not cutting out any particular foods/quasi-foods, but I am restricting carbohydrate to one serving in each meal and snack. One piece of fruit. One potato. One slice of bread. A couple of squares of chocolate. I know that so far my blood glucose levels are totally under my control as long as I watch my carbohydrate intake.
I don't know how I can have little bursts of worry about this then slip back into apathy - or at least not caring enough to stay committed.
My other area of focus right now is my sleep apnoea. With people inspecting our home I would have had to pack up and unpack the CPAP three times a week and I just couldn't be bothered. Also I've had the flu with runny nose and sore throat and cough etc, which does not go at all well with a CPAP mask (I use nose pillows). The result is, I haven't used it for a month or so. Well my flu is better (finally) and today is the last inspection with the auction this evening. No more excuses. I'm using my CPAP every night until we move (I like short term goals). I hate wearing it, but I need it. My brain needs oxygen. And it's hard to be at my best when I'm constantly tired.
The past couple of weeks I've been saying to myself "I'm too stressed right now, I'll worry about it after we sell the house" so it might seem odd I'm talking about this today rather than tomorrow (assuming we even sell tonight). But my body is giving me very clear signals I need to deal with it now. And what am I asking of myself, after all? Eat a bit less carb, wear my CPAP. Hardly torture.
Sunday, June 28, 2015
Health issues - the results
Monday:
I saw my doctor and the sleep clinic today and got a lot of results back, good and bad. I'm going to list them all here, mainly for my own records.
Firstly I saw the technician at the sleep clinic. I'd had the borrowed CPAP brain for two weeks to get some more readings on how I'm sleeping. The result is that my tiredness doesn't seem to have anything to do with my sleep apnoea. The machine is working well, I'm using it correctly, I'm having a sleep apnoea "event" on average 0.1 times per hour (that is about once every second night), which is negligible. They have now increased the air pressure to eliminate even that occasional event, but it's not really going to make any difference. So, that was not the problem.
Then I saw my GP (general practitioner, my family doctor) to get the results of my glucose tolerance (diabetes) test and all the other blood readings. That was interesting and a bit scary.
Four years ago, when I was first flagged as having pre-diabetes / glucose intolerance, my blood glucose was 10.0 mmol/L. Normal is 7.7, diabetes is 11.0. So it wasn't good. I worked on it. Two years ago it was down to 8.2, nearly normal. Great work Natalie. Today it was up to 10.8 mmol/L. That is not good at all. It's 0.2 from a diagnosis of diabetes. Doubly bad, with my father recently dying of (probably) diabetes complications. I have gained weight back over the past couple of years, I was down to 78 kg for a while, I desperately need to lose it again, and more. This morning I was at my highest for a long time: 84.8 kg. That is a couple of kilograms (5 pounds) in less than two weeks. I was hoping the weight gain was partly a monthly fluctuation, but apparently not.
Obviously it's time, way past time, to get really really serious about my health.
That wasn't the only result. The next most important was my level of B12, which are very low. It seems I'm not absorbing B12 from food. And guess what, low levels of B12 make you very tired. We may well have a solution to my constant fatigue. I'm now on Vitamin B12 supplements for 2 or 3 months, then will be retested. If I still can't absorb the vitamin from the tablets, as is quite likely, I will need regular injections of it. This was completely unexpected news! Lucky I'm not scared of needles. In a way I am excited about this result, because it means I might finally get a resolution to my constant tiredness. An injection every month or so in return for normal levels of energy? Bring it on! Or maybe the pills will help, which is even better.
My cholesterol is too high. I've always had high cholesterol, but last test it was down to almost normal. This time is was up again, to 6.2. Should be 3.5--5.5. Probably tied to my obesity, and another reason to lose weight.
My blood platelets are up a little bit. High enough for my doctor to point it out, but not high enough to worry, she said. They can go up due to an infection, so if I had a cold or something (and I have had a sore throat) that can cause the reading. When I got home I looked it up and the other thing that causes increased blood platelets is cancer. Ah, the internet, so comforting. I'm trying not to worry about that at this stage. I was only a little above normal. But another thing to keep an eye on.
And finally my Vitamin D levels are low. I was put on tablets for this before, but stopped taking them (without consulting my doctor) when I started walking regularly and was getting plenty of sunlight. That fizzed out a while ago. So now I'm back on the pills.
I'll be tracking food, counting calories and carbohydrates. And exercising every day.
I saw my doctor and the sleep clinic today and got a lot of results back, good and bad. I'm going to list them all here, mainly for my own records.
Firstly I saw the technician at the sleep clinic. I'd had the borrowed CPAP brain for two weeks to get some more readings on how I'm sleeping. The result is that my tiredness doesn't seem to have anything to do with my sleep apnoea. The machine is working well, I'm using it correctly, I'm having a sleep apnoea "event" on average 0.1 times per hour (that is about once every second night), which is negligible. They have now increased the air pressure to eliminate even that occasional event, but it's not really going to make any difference. So, that was not the problem.
Then I saw my GP (general practitioner, my family doctor) to get the results of my glucose tolerance (diabetes) test and all the other blood readings. That was interesting and a bit scary.
Four years ago, when I was first flagged as having pre-diabetes / glucose intolerance, my blood glucose was 10.0 mmol/L. Normal is 7.7, diabetes is 11.0. So it wasn't good. I worked on it. Two years ago it was down to 8.2, nearly normal. Great work Natalie. Today it was up to 10.8 mmol/L. That is not good at all. It's 0.2 from a diagnosis of diabetes. Doubly bad, with my father recently dying of (probably) diabetes complications. I have gained weight back over the past couple of years, I was down to 78 kg for a while, I desperately need to lose it again, and more. This morning I was at my highest for a long time: 84.8 kg. That is a couple of kilograms (5 pounds) in less than two weeks. I was hoping the weight gain was partly a monthly fluctuation, but apparently not.
Obviously it's time, way past time, to get really really serious about my health.
That wasn't the only result. The next most important was my level of B12, which are very low. It seems I'm not absorbing B12 from food. And guess what, low levels of B12 make you very tired. We may well have a solution to my constant fatigue. I'm now on Vitamin B12 supplements for 2 or 3 months, then will be retested. If I still can't absorb the vitamin from the tablets, as is quite likely, I will need regular injections of it. This was completely unexpected news! Lucky I'm not scared of needles. In a way I am excited about this result, because it means I might finally get a resolution to my constant tiredness. An injection every month or so in return for normal levels of energy? Bring it on! Or maybe the pills will help, which is even better.
My cholesterol is too high. I've always had high cholesterol, but last test it was down to almost normal. This time is was up again, to 6.2. Should be 3.5--5.5. Probably tied to my obesity, and another reason to lose weight.
My blood platelets are up a little bit. High enough for my doctor to point it out, but not high enough to worry, she said. They can go up due to an infection, so if I had a cold or something (and I have had a sore throat) that can cause the reading. When I got home I looked it up and the other thing that causes increased blood platelets is cancer. Ah, the internet, so comforting. I'm trying not to worry about that at this stage. I was only a little above normal. But another thing to keep an eye on.
And finally my Vitamin D levels are low. I was put on tablets for this before, but stopped taking them (without consulting my doctor) when I started walking regularly and was getting plenty of sunlight. That fizzed out a while ago. So now I'm back on the pills.
I'll be tracking food, counting calories and carbohydrates. And exercising every day.
Wednesday, November 12, 2014
Diet bet and the perfect diet
Thursday:
I am planning to try a diet bet, starting on Monday. I've read of a few other people doing them and it all seems legit. No idea if it will help me or not but I'll give it a go. What happens is you join a group (or start your own) that is starting on a day that suits you and you pay the ante - generally around $25. If you lose the requisite amount of weight (4% of bodyweight in 4 weeks or 10% in 6 months depending on the group) you get to share the pot. It seems that on average around 40% of people succeed so after the facilitators take their cut you get between 1.5x and 2x your money back. If you don't lose the weight you lose your ante. At my current weight I would have to lose 3.3 kg (7.3 pounds) in the 4 weeks, which I would love to do before Christmas and it seems like it should be do-able. Any extra motivation would be awesome.
I felt quite unwell again yesterday, maybe too much running around the day before, but I rested up and I'm mostly better again today. I did some more clothes shopping today and bought a couple of pretty tops for Christmas. As it is always very hot here on the day, middle of summer, dress is casual. I found something I was very happy with today. I am so glad that I am not hating my body at the moment. Of course I want to lose weight, I wish I was 25 kg lighter right this second, but that is no reason to hate myself as I am. I am still me and can still look quite nice. I picked up my tailored pants (with the legs shortened for me) and I also lightened my hair again, all ready for the wedding. Ready to face the extended family and pretend I don't feel like a hen amongst flamingos.
With worries about my pre-diabetes possibly getting worse - my blood glucose levels have been consistently high for days after even moderate amounts of carbohydrate - I revisited my recommendations for the diabetic diet. It is all so confusing. My diabetes nutritionist told me to eat regular doses of carbohydrate at every meal and snack, in amounts that seemed bewilderingly large to me although some other people in my class still didn't think it was enough, to keep my blood glucose steady. The official guidelines seem to be the same for Australia, US, UK etc. But there is a huge community of diabetics out there on the forums who say it is much better to eat almost no carbohydrate at all. They eat less in a whole day than the dieticians say to eat in a single snack. There is a lot of support for LC/HF (low carb/high fat) diets. These people say that low carb is much better than moderate carbs for keeping blood sugars low. On the nutritionist recommended diet they seem to expect you to gradually get worse and need various medication, that is the normal progression. And the LC/HF people say that of course that is the progression if you keep eating lots of carbs!
I personally don't like eating high fat, it makes me feel sick and greasy. And I am unwilling to approve any diet that greatly restricts fruit and even many vegetables. But I don't think lots of carbs is good either (and I'd never lose any weight, which is very important for diabetic health). Is there a compromise?
I think I have a pretty clear idea now of what I think the "perfect" diet is (for me, at least), and it is summed up by Michael Pollan's "Eat food, not too much, mostly plants."
I am planning to try a diet bet, starting on Monday. I've read of a few other people doing them and it all seems legit. No idea if it will help me or not but I'll give it a go. What happens is you join a group (or start your own) that is starting on a day that suits you and you pay the ante - generally around $25. If you lose the requisite amount of weight (4% of bodyweight in 4 weeks or 10% in 6 months depending on the group) you get to share the pot. It seems that on average around 40% of people succeed so after the facilitators take their cut you get between 1.5x and 2x your money back. If you don't lose the weight you lose your ante. At my current weight I would have to lose 3.3 kg (7.3 pounds) in the 4 weeks, which I would love to do before Christmas and it seems like it should be do-able. Any extra motivation would be awesome.
I felt quite unwell again yesterday, maybe too much running around the day before, but I rested up and I'm mostly better again today. I did some more clothes shopping today and bought a couple of pretty tops for Christmas. As it is always very hot here on the day, middle of summer, dress is casual. I found something I was very happy with today. I am so glad that I am not hating my body at the moment. Of course I want to lose weight, I wish I was 25 kg lighter right this second, but that is no reason to hate myself as I am. I am still me and can still look quite nice. I picked up my tailored pants (with the legs shortened for me) and I also lightened my hair again, all ready for the wedding. Ready to face the extended family and pretend I don't feel like a hen amongst flamingos.
With worries about my pre-diabetes possibly getting worse - my blood glucose levels have been consistently high for days after even moderate amounts of carbohydrate - I revisited my recommendations for the diabetic diet. It is all so confusing. My diabetes nutritionist told me to eat regular doses of carbohydrate at every meal and snack, in amounts that seemed bewilderingly large to me although some other people in my class still didn't think it was enough, to keep my blood glucose steady. The official guidelines seem to be the same for Australia, US, UK etc. But there is a huge community of diabetics out there on the forums who say it is much better to eat almost no carbohydrate at all. They eat less in a whole day than the dieticians say to eat in a single snack. There is a lot of support for LC/HF (low carb/high fat) diets. These people say that low carb is much better than moderate carbs for keeping blood sugars low. On the nutritionist recommended diet they seem to expect you to gradually get worse and need various medication, that is the normal progression. And the LC/HF people say that of course that is the progression if you keep eating lots of carbs!
I personally don't like eating high fat, it makes me feel sick and greasy. And I am unwilling to approve any diet that greatly restricts fruit and even many vegetables. But I don't think lots of carbs is good either (and I'd never lose any weight, which is very important for diabetic health). Is there a compromise?
I think I have a pretty clear idea now of what I think the "perfect" diet is (for me, at least), and it is summed up by Michael Pollan's "Eat food, not too much, mostly plants."
"Eat food" means to eat real food - vegetables, fruits, whole grains, dairy and meat. Nothing that has a shelf life of several years - if it won't rot, it isn't real food. And mostly plant food is healthiest, lots of fruit and vegetables of as many varieties as you can get.
I don't ban fruit from my "perfect" diet even though it has natural sugars. I don't ban grain even though it has gluten. I don't ban dairy even though it has lots of fat. I don't have sensitivities to any particular foods so that would be an issue for some but not me. But there is very little room in my perfect diet for anything heavily processed. Basically anything that comes in a packet. If it needs a label with nutritional information on it, I probably shouldn't be eating it. And there needs to be portion control even with the best of foods.
So why don't I follow this perfect diet? Because the other junk is so tempting! Still working on it, every day.
I saw a bit of a documentary the other day about meat consumption and they were saying that for environmental sustainability (with the world's population continuing to expand but the land available remaining the same) we should be consuming around 100 grams of meat per person per day. I eat a lot more meat than that. But we are running out of forests to cut down to make more farm land for our cows and sheep so rich people can keep stuffing themselves with meat. It's another thing to take into consideration.
Tuesday, November 11, 2014
New clothes
Tuesday:
I had a very busy but productive day today. I spent basically the entire morning looking for something to wear to this wedding on Friday. I was running out of time to buy, especially as a lot of things I buy have to be altered to fit because I am so short. Today I was feeling much better, nearly over my cold, so I was up to stressful shopping. Clothes shopping is definitely stressful when you are unhappy with the way you look in just about anything. You have to compromise between finding something you think you look good in and realising that you are not going to look like Elle McPhearson no matter how many dresses you try on. Every outfit you ask "is this as good as it gets?"
I chose a pair of floaty black pants, very interesting actually and not at all like work trousers, and a floaty purple top. I felt a bit like a gypsy. It is going to be a stinking hot day but I decided I would be more comfortable in loose pants than with my thighs rubbing together. I was happy with my eventual choice.
Then I realised how late it was getting and rushed to my hair appointment without having any time for lunch. Happy with my haircut too. I'll take a picture when I'm all made up and not so much red nose and bleary eyes.
At 2pm (so late for me, I always eat at noon) I grabbed lunch, put in the trousers for alteration, got a script at the chemist and asked them to check my blood pressure. The lady tried four times but kept getting an error message. All that arm-squeezing pain for nothing! I'll have to wait for my doctor next week. My blood sugars have been consistently high yesterday and today (I hadn't checked it for a while before that) but apparently being sick can mess with that. If you're diabetic. I've booked in for the diabetes blood test I didn't have six months ago, next Monday when presumably I'll be completely over my cold so the results should be accurate. The great news is you no longer need to carb load for three days beforehand! I always hated doing that. But I am definitely a bit worried, my pre-diabetes had seemed to be improving last time I was tested 18 months ago.
I got home just minutes before the kids and their playdate guests, had a nice chat with my friend, took my daughter to dance, got a rotisserie chicken on the way home because I hadn't had time to do grocery shopping today, then had Dungeons and Dragons night. I'm really not enjoying it at all lately, my favourite bit is the combat and we get to do that about one session in four this campaign (usually it should be every session, or I think so anyway!). It's all debate about what to do next and how to achieve our goals. Hours of it. Boring. I want to charge in and kill the monsters! But we can't because they are usually too tough for us and we have to be sneaky and clever. Blah. I spend a lot of type rudely playing with my phone. But they know how I feel.
At least with the playdate and the games night I put out all the rest of the cake and party leftovers so that is all gone instead of sitting around tempting me. I'd already tipped chips into the bin to avoid eating the whole packet after I couldn't resist opening them. Gone now.
I had a very busy but productive day today. I spent basically the entire morning looking for something to wear to this wedding on Friday. I was running out of time to buy, especially as a lot of things I buy have to be altered to fit because I am so short. Today I was feeling much better, nearly over my cold, so I was up to stressful shopping. Clothes shopping is definitely stressful when you are unhappy with the way you look in just about anything. You have to compromise between finding something you think you look good in and realising that you are not going to look like Elle McPhearson no matter how many dresses you try on. Every outfit you ask "is this as good as it gets?"
I chose a pair of floaty black pants, very interesting actually and not at all like work trousers, and a floaty purple top. I felt a bit like a gypsy. It is going to be a stinking hot day but I decided I would be more comfortable in loose pants than with my thighs rubbing together. I was happy with my eventual choice.
Then I realised how late it was getting and rushed to my hair appointment without having any time for lunch. Happy with my haircut too. I'll take a picture when I'm all made up and not so much red nose and bleary eyes.
At 2pm (so late for me, I always eat at noon) I grabbed lunch, put in the trousers for alteration, got a script at the chemist and asked them to check my blood pressure. The lady tried four times but kept getting an error message. All that arm-squeezing pain for nothing! I'll have to wait for my doctor next week. My blood sugars have been consistently high yesterday and today (I hadn't checked it for a while before that) but apparently being sick can mess with that. If you're diabetic. I've booked in for the diabetes blood test I didn't have six months ago, next Monday when presumably I'll be completely over my cold so the results should be accurate. The great news is you no longer need to carb load for three days beforehand! I always hated doing that. But I am definitely a bit worried, my pre-diabetes had seemed to be improving last time I was tested 18 months ago.
I got home just minutes before the kids and their playdate guests, had a nice chat with my friend, took my daughter to dance, got a rotisserie chicken on the way home because I hadn't had time to do grocery shopping today, then had Dungeons and Dragons night. I'm really not enjoying it at all lately, my favourite bit is the combat and we get to do that about one session in four this campaign (usually it should be every session, or I think so anyway!). It's all debate about what to do next and how to achieve our goals. Hours of it. Boring. I want to charge in and kill the monsters! But we can't because they are usually too tough for us and we have to be sneaky and clever. Blah. I spend a lot of type rudely playing with my phone. But they know how I feel.
At least with the playdate and the games night I put out all the rest of the cake and party leftovers so that is all gone instead of sitting around tempting me. I'd already tipped chips into the bin to avoid eating the whole packet after I couldn't resist opening them. Gone now.
Tuesday, May 13, 2014
Time for another test
Wednesday:
My, doesn't time fly. (And what an original thought!) I just got a letter from my doctor saying it's been a year since my last diabetes test and it was time for another one. I've made an appointment with my doctor next Wednesday, she's very hard to get in to see, so I can get a referral, then I do the three day carb load which would mean I couldn't do the test until the week after...
Hmm, we get the puppy that weekend so I don't want to spend three hours away from home just then. Maybe I should book the test and start the carb loading early so I can do the actual test the day after I pick up the referral instead of three days later. I only have to show the referral when I actually go for the test, and I can get the carb-load info off the web-site. I don't need to wait until I have the referral before I start the next step in the process. I am brilliant!
We need to buy all the stuff for the puppy, too. A little doggy bed and everything.
Anyway, I was surprised to get this letter because it seems not very long ago that I had my last diabetes test. At that time I'd had pre-diabetes for a year and thought I had improved but then during the test became convinced I'd got worse. So when I saw the doctor for my results I was deeply sure that I had diabetes and when she told me my blood sugar was down near normal level I nearly fell off my chair. I'd been right the first time.
This time I am very unsure. I haven't thought to check my blood at home for ages, although I have the equipment (from when I had gestational diabetes). I have gained quite a bit of weight these past four of five months - due to the sleep apnoea I believe - and I'm not sure how sleep apnoea itself, or the high blood pressure caused by the sleep apnoea, interact with insulin resistance. All those factors interact with each other. So it wouldn't be that surprising if my insulin resistance is worse.
I just did a very unscientific test on myself. I think it is about two hours since I had a afternoon tea but it's supposed to be exactly two hours - and also I just had about eight m&ms half an hour ago, so this test means little. But 8.4 mmol/L (151 mg/dL) is a bit higher than it should be at any time (ie even straight after eating m&ms) if I didn't have insulin resistance. If forced to guess from that limited information, I would say I am still within the pre-diabetic range. Obviously worth checking properly.
My, doesn't time fly. (And what an original thought!) I just got a letter from my doctor saying it's been a year since my last diabetes test and it was time for another one. I've made an appointment with my doctor next Wednesday, she's very hard to get in to see, so I can get a referral, then I do the three day carb load which would mean I couldn't do the test until the week after...
Hmm, we get the puppy that weekend so I don't want to spend three hours away from home just then. Maybe I should book the test and start the carb loading early so I can do the actual test the day after I pick up the referral instead of three days later. I only have to show the referral when I actually go for the test, and I can get the carb-load info off the web-site. I don't need to wait until I have the referral before I start the next step in the process. I am brilliant!
We need to buy all the stuff for the puppy, too. A little doggy bed and everything.
Anyway, I was surprised to get this letter because it seems not very long ago that I had my last diabetes test. At that time I'd had pre-diabetes for a year and thought I had improved but then during the test became convinced I'd got worse. So when I saw the doctor for my results I was deeply sure that I had diabetes and when she told me my blood sugar was down near normal level I nearly fell off my chair. I'd been right the first time.
This time I am very unsure. I haven't thought to check my blood at home for ages, although I have the equipment (from when I had gestational diabetes). I have gained quite a bit of weight these past four of five months - due to the sleep apnoea I believe - and I'm not sure how sleep apnoea itself, or the high blood pressure caused by the sleep apnoea, interact with insulin resistance. All those factors interact with each other. So it wouldn't be that surprising if my insulin resistance is worse.
I just did a very unscientific test on myself. I think it is about two hours since I had a afternoon tea but it's supposed to be exactly two hours - and also I just had about eight m&ms half an hour ago, so this test means little. But 8.4 mmol/L (151 mg/dL) is a bit higher than it should be at any time (ie even straight after eating m&ms) if I didn't have insulin resistance. If forced to guess from that limited information, I would say I am still within the pre-diabetic range. Obviously worth checking properly.
Tuesday, July 16, 2013
Pre-pre-diabeties test
Wednesday:
It's been nearly a year since I found out I had pre-diabetes and last time I saw my doctor a couple of months ago (actually it was the first time I saw this new doctor who I am going to stick with) she gave me a referral for another test. Glucose tolerance, plus iron and folate and everything else she could think of. There is a list of 13 things to test for! I assume they do it all with the same bit of blood? Or not too many vials, anyway.
I've booked the test in for next week. The GTT (glucose tolerance) requires three days of "carb loading" then a fast. I always complain about the carb loading because it is so much starch/sugar -- much more than I usually eat -- but this time I am going to enjoy it while I can before I cut right back afterwards.
I found that giving up on losing weight makes me even unhappier than trying and failing. The trying is also difficult and unpleasant, but right now I'm in the best of all possible worlds; holiday indulgence/doctor-mandated carb-loading but with the virtuous feeling that I am going to start being "good" very soon. That's kind of a joke, but true at the same time. The "I'll start on Monday" promise that lets you feel good about yourself while not actually making any changes in the now. Giving up your cake and eating it too.
We had spaghetti bolognaise last night, obviously a high-carb meal, so I tested my blood two hours later -- something I haven't done for a while. Not as accurate as the real GTT but gives me an indication. It was 8.5 mmol/L (up to 7.8 is normal, 11.0 is diabetes) which is a little high but not too bad. I don't expect this GTT to say I have diabetes. Probably still in the pre-diabetes range. It will be interesting to see if I am better or worse, because I did work hard for a while (before I got slack again, but never as bad as I used to be) on eating low GI foods, not too many carbs at once etc. I hope a bit better.
My main anti-diabetes goal was to lose weight and I have failed at that. Right now I am a couple of kgs heavier than I was then. Not a big increase, but it should be a loss not a gain.
I seem to be having two hormonal emotional slumps each cycle instead of just PMS (something to discuss with my doctor) but I feel a lot more hopeful today than when I wrote the last post.
It's been nearly a year since I found out I had pre-diabetes and last time I saw my doctor a couple of months ago (actually it was the first time I saw this new doctor who I am going to stick with) she gave me a referral for another test. Glucose tolerance, plus iron and folate and everything else she could think of. There is a list of 13 things to test for! I assume they do it all with the same bit of blood? Or not too many vials, anyway.
I've booked the test in for next week. The GTT (glucose tolerance) requires three days of "carb loading" then a fast. I always complain about the carb loading because it is so much starch/sugar -- much more than I usually eat -- but this time I am going to enjoy it while I can before I cut right back afterwards.
I found that giving up on losing weight makes me even unhappier than trying and failing. The trying is also difficult and unpleasant, but right now I'm in the best of all possible worlds; holiday indulgence/doctor-mandated carb-loading but with the virtuous feeling that I am going to start being "good" very soon. That's kind of a joke, but true at the same time. The "I'll start on Monday" promise that lets you feel good about yourself while not actually making any changes in the now. Giving up your cake and eating it too.
We had spaghetti bolognaise last night, obviously a high-carb meal, so I tested my blood two hours later -- something I haven't done for a while. Not as accurate as the real GTT but gives me an indication. It was 8.5 mmol/L (up to 7.8 is normal, 11.0 is diabetes) which is a little high but not too bad. I don't expect this GTT to say I have diabetes. Probably still in the pre-diabetes range. It will be interesting to see if I am better or worse, because I did work hard for a while (before I got slack again, but never as bad as I used to be) on eating low GI foods, not too many carbs at once etc. I hope a bit better.
My main anti-diabetes goal was to lose weight and I have failed at that. Right now I am a couple of kgs heavier than I was then. Not a big increase, but it should be a loss not a gain.
I seem to be having two hormonal emotional slumps each cycle instead of just PMS (something to discuss with my doctor) but I feel a lot more hopeful today than when I wrote the last post.
Wednesday, January 30, 2013
Pre-diabetic husband
Wednesday:
A week ago, a couple of hours after dinner, I tested Tim's blood sugar. I'd never done it before and had no reason to believe he had any blood glucose problems, he had full blood-work about a year before. He isn't overweight and he exercises a lot, but he does have high blood pressure (almost certainly caused by work stress and currently controlled by medication). The meter came up with the figure 10.1 mmol/L. Around equal to the highest I've ever had.
I was worried, but he had just eaten a couple of apricot delight. They couldn't have got to his blood stream yet (I think) but I figured he might have had sugar on his finger which would have skewed the test. I decided to test again after a high carbohydrate meal.
Tonight we had lasagne and then a big serve of ice cream for dessert. I calculated it was approaching 90 grams of carbohydrate -- which is twice what my dietitian suggested I have. I tested Tim. 9.7 mmol/L. I tested myself. 8.3 mmol/L.
His blood sugar is worse than mine.
Obviously this was not a proper test under the strict conditions they use for diagnosing diabetes, but it is indicative of a problem. Blood glucose for a person without impaired glucose tolerance should never go over 7.8, regardless of how much carbohydrate they eat.
I think we can assume pre-diabetes.
I am shocked and very worried. He has gone from very healthy a couple of years ago to suddenly very high blood pressure and pre-diabetes. High blood pressure is a risk factor so that comes into it, but diet must also play a part.
I control his diet.
I do all the shopping and all the cooking. Apart from the occasional restaurant meal or snack while out with the kids, he only eats what I provide. What have I been feeding us to get us both into this state?
My biggest challenge is to lose weight. His will be to manage his carbohydrate intake. He is a real carb addict; he loves sugary sweets and bread and pasta. If I serve a meal with meat and vegetable and no starch, he will go and have a couple of pieces of toast with honey afterwards.
We both need to do this. Diabetes is scary, but it isn't too late to reverse the process.
When I had gestational diabetes, I stuck to my diet because it was for my baby's sake. I've struggled to stay motivated for just my own health. But now I have two of us to look after again.
A week ago, a couple of hours after dinner, I tested Tim's blood sugar. I'd never done it before and had no reason to believe he had any blood glucose problems, he had full blood-work about a year before. He isn't overweight and he exercises a lot, but he does have high blood pressure (almost certainly caused by work stress and currently controlled by medication). The meter came up with the figure 10.1 mmol/L. Around equal to the highest I've ever had.
I was worried, but he had just eaten a couple of apricot delight. They couldn't have got to his blood stream yet (I think) but I figured he might have had sugar on his finger which would have skewed the test. I decided to test again after a high carbohydrate meal.
Tonight we had lasagne and then a big serve of ice cream for dessert. I calculated it was approaching 90 grams of carbohydrate -- which is twice what my dietitian suggested I have. I tested Tim. 9.7 mmol/L. I tested myself. 8.3 mmol/L.
His blood sugar is worse than mine.
Obviously this was not a proper test under the strict conditions they use for diagnosing diabetes, but it is indicative of a problem. Blood glucose for a person without impaired glucose tolerance should never go over 7.8, regardless of how much carbohydrate they eat.
I think we can assume pre-diabetes.
I am shocked and very worried. He has gone from very healthy a couple of years ago to suddenly very high blood pressure and pre-diabetes. High blood pressure is a risk factor so that comes into it, but diet must also play a part.
I control his diet.
I do all the shopping and all the cooking. Apart from the occasional restaurant meal or snack while out with the kids, he only eats what I provide. What have I been feeding us to get us both into this state?
My biggest challenge is to lose weight. His will be to manage his carbohydrate intake. He is a real carb addict; he loves sugary sweets and bread and pasta. If I serve a meal with meat and vegetable and no starch, he will go and have a couple of pieces of toast with honey afterwards.
We both need to do this. Diabetes is scary, but it isn't too late to reverse the process.
When I had gestational diabetes, I stuck to my diet because it was for my baby's sake. I've struggled to stay motivated for just my own health. But now I have two of us to look after again.
Tuesday, November 27, 2012
The magic sleeping tissue
I've been sleeping really badly for at least a week. Taking a long time to get to sleep, waking during the night, waking very early and not being able to get back to sleep. Leaving me an exhausted wreck, you may have noticed several mentions of afternoon naps lately. But last night the magic sleeping tissue wafted me to a great night's sleep.
Now you may argue that the heat has been interrupting my sleep (although I think the disruption started before it got really hot) and that yesterday's storm followed by a cool front helped me sleep. I beg to differ. I am finally realising the power of the tissue.
A few times in the past when I've had a bad cold I've ended up falling asleep with a tissue bunched in one exhausted hand (generally a clean tissue, at the ready). Somehow I have then slept soundly through the night despite coughs and mucus, and woken with the tissue still securely held like a soft little talisman.
Last night I didn't have a cold, but had a drink from my bedside cup of water and spilled a few drops. I wiped my pillow and somehow went to sleep still holding the tissue. And slept deeply and well for the first time in a week.
I'm kind of joking, but maybe I do get some kind of psychological benefit from holding something through the night, like a kid's security blanket. Something to look after through the night, while at the same time it looks after me.
45 mins walking and 45 mins high intensity dancing this morning, which I think is a good effort on a day I also had my son's school assembly (I had to go because Kindergarten was hosting today) and did some editing work.
I wrote to the dietitian at the diabetes clinic about my consistently low blood sugar and how I was eating less carbs that she had originally suggested and she said both were fine. So I don't need to worry about that as long as I stay consistent and feel okay. She thought I would probably get hungry between meals and need snacks, and I do, but that is fine too.
When I logged in today I found ads on my blog list that covered up things I wanted to read, and then when I looked at Monday's post it had random words linking to advertisements! Arg! I'm not sure what to do about it. But then I read someone else's blog and they had the same thing, so hopefully there will be huge outcry and it will be stopped and the spamming advertisers will all be jailed with the cockroaches and the rats and the malarial mosquitos.
photo by ajalfaro
Saturday, November 24, 2012
Shopping for outdoor furniture
Saturday:
We spent quite a bit of today out looking at outdoor furniture. We don't have any currently, and also we won't have enough chairs and table-space for Christmas so it seemed like a good time to buy something that could be brought inside for a couple of days and added to the dining table and kitchen table. We narrowed it down to a couple of sets of similar price, with each child loving a different one from each other and Tim & I liked both. We ended up getting the set that I liked slightly less but would be much easier to clean (the wicker one would have been a nightmare for spiderwebs). It will be delivered on Tuesday and then we have to work on making the area under the awning, which now just has the BBQ, inviting to sit in. I plan to dump some dead and/or dying plants out of a few pots and getting some new plants in to decorate the area. We've been paying a gardener for the past few months and the garden as a whole is looking a lot tidier. And there are quite a few things in our vege patch now.
We had a really nice lunch in a restaurant and did some clothes shopping for Tim, so we were out much of the day. When we got home I had a bit of a lie down.
I ran out of blood testing strips today which has stopped me turning myself into a pincushion. I did manage to test two hours after the restaurant and got an excellent result. I found a diabetes forum on the internet but I'm not really sure how reputable it is or if I've stumbled on a group anti-establishment rebels. I talked about my low blood sugar readings and they (about four different people) argued that the lower the better, diabetes associations set the numbers way too high when the blood glucose is already damaging your body, and that I should be on a much lower carb diet. This all sounded quite reasonable although different to the advice I was given by the dietitian. But then one person said they have about 20-30 grams of carbs a DAY which must mean no fruit and very limited vegetables as well as no bread etc. When s/he said they followed an Atkins diet they totally lost any credibility with me. Another person gave me a link to a site that said low GI is rubbish (because low GI foods have just as much carbohydrate you need to produce just as much insulin, just over a longer timeframe, which is true but doesn't mean that isn't better than having to produce a lot quickly).
I have been struggling to eat the 45g of carbs my dietitian recommended so I'll keep eating the 25-30g per meal that is comfortable for me + snacks and keep monitoring my blood sugar and how I feel. If I keep having worrying symptoms I will contact my dietitian. Not strangers on the internet.
We spent quite a bit of today out looking at outdoor furniture. We don't have any currently, and also we won't have enough chairs and table-space for Christmas so it seemed like a good time to buy something that could be brought inside for a couple of days and added to the dining table and kitchen table. We narrowed it down to a couple of sets of similar price, with each child loving a different one from each other and Tim & I liked both. We ended up getting the set that I liked slightly less but would be much easier to clean (the wicker one would have been a nightmare for spiderwebs). It will be delivered on Tuesday and then we have to work on making the area under the awning, which now just has the BBQ, inviting to sit in. I plan to dump some dead and/or dying plants out of a few pots and getting some new plants in to decorate the area. We've been paying a gardener for the past few months and the garden as a whole is looking a lot tidier. And there are quite a few things in our vege patch now.
We had a really nice lunch in a restaurant and did some clothes shopping for Tim, so we were out much of the day. When we got home I had a bit of a lie down.
I ran out of blood testing strips today which has stopped me turning myself into a pincushion. I did manage to test two hours after the restaurant and got an excellent result. I found a diabetes forum on the internet but I'm not really sure how reputable it is or if I've stumbled on a group anti-establishment rebels. I talked about my low blood sugar readings and they (about four different people) argued that the lower the better, diabetes associations set the numbers way too high when the blood glucose is already damaging your body, and that I should be on a much lower carb diet. This all sounded quite reasonable although different to the advice I was given by the dietitian. But then one person said they have about 20-30 grams of carbs a DAY which must mean no fruit and very limited vegetables as well as no bread etc. When s/he said they followed an Atkins diet they totally lost any credibility with me. Another person gave me a link to a site that said low GI is rubbish (because low GI foods have just as much carbohydrate you need to produce just as much insulin, just over a longer timeframe, which is true but doesn't mean that isn't better than having to produce a lot quickly).
I have been struggling to eat the 45g of carbs my dietitian recommended so I'll keep eating the 25-30g per meal that is comfortable for me + snacks and keep monitoring my blood sugar and how I feel. If I keep having worrying symptoms I will contact my dietitian. Not strangers on the internet.
Thursday, November 22, 2012
Too low
At the moment, after my scare on Wednesday, my whole focus is on food. All day it's: what am I eating next? When? Does it have enough carbs? Too many carbs? Is it low-GI? Is it time to test my blood glucose again yet? Has two hours passed since I last ate so I can test my blood then have a snack?
Yesterday I was so paranoid about my blood sugar going too high that I didn't have enough carbs. My blood sugar was too low (not hypo-low, but within the range it should be before breakfast not where it should be after meals) and I felt tired and lackluster all day. Then I had pasta for dinner and my blood sugar went up appropriately and I suddenly felt much better.
I tried to eat a bit more carbohydrate at breakfast today but my blood sugar was stubbornly low two and a half hours later (I wasn't home to check at the two hour point). I am still waiting to test for lunch. Who would have thought it would be hard to get my blood glucose high enough?
I went for two walks yesterday, today I plan to do some dancing once I've digested lunch a bit. We've had a cool spring but it is starting to heat up now that we're only a week away from summer so I think I'm going to have to move the exercise indoors into air conditioning. The gym and the Kinect. I may end up putting off running until autumn, which is a bit of a shame, but my fair skin and I are not fans of summer. It's not really hot yet, so I could still do some running training. Exercise isn't wasted even if I don't end up doing a 5K race this year.
One of the best things about summer (still thinking about food, I'm afraid) is all the lovely fruit. Apples and oranges and kiwi fruit are nice enough, but then the weather warms up and the fruit bowl is full of mangos and peaches and nectarines and grapes and passionfruit and strawberries and watermelon. Today at the shops I bought a whole tray of mangos. Our neighbours over the back fence have a row of fruit trees that reach over our side. Last year they trimmed them all back hard and we got nothing (very disappointing) but the kids are already harvesting mulberries every day and I think there is going to be a bumper crop of plums. There is a quince tree too, I've never tried one but I understand you have to cook them because they are very astringent. Then again, some people say you have to cook tamarillos and I love them raw. I like my fruit tangy sour. I'll grab a couple of quinces if any come over our side.
photo of mulberry by Rosh Sillars
later: still low after my carefully carb-counted lunch, even lower after exercise during which I felt quite dizzy. If this continues over the weekend I will contact the diabetes people to get some help managing my levels.
Tuesday, November 20, 2012
F*ck
I just got a blood glucose reading of 10.8 mmol/L. Do you know when they call it diabetes? 11.0. Ok, that is 11.0 in carefully controlled circumstances exactly two hours after 75g of carbs with you sitting calmly the whole time after eight hours of fasting after three days of carb loading. But still, this is a horribly high number, the highest I've ever had. I am feeling really scared right now but that is a good thing. I need to keep this level of urgency, this determination.
I had a healthy lunch of chicken and salad. But I'm supposed to have carbs with each meal, so then I had some rice crackers that I bought before last Wednesday when I was told they were high GI. I wasn't ever going to buy more, but a shame to waste the yummy ones I already had, right? I had the amount of carbs allowed for the meal. Less than an hour later I started to feel a bit odd. It's hard to describe, but I've come to recognise a certain feeling as meaning my blood gluscose is high. I tested myself, and it was 10.8 mmol/L. Way above the "normal person's" high of 8 (which is what I aim for), above the "acceptable for a diabetic" 10.
I went to pick up the kids, feeling scared and trembly and very self-critical for my stupidity. When I tested myself again my blood glucose was down to 9.4. I'm not sure exactly what time I ate the rice crackers but this is probably around the 2 hour point.
I am absolutely determined that this lesson is now learned. It is not just the amount of carbs, but the type that matters. No high-GI foods.
The snack cuboard has gradually filled again since I last cleared it. Mostly stuff for the kid's school lunchbox, semi-junk like muesli bars and fruit sticks. But quite a few blocks of chocolate; my own purchases and left-overs. Chocolate biscuits (mine). The rice crackers (now gone, I gave the rest to the kids). A few random lollies left from Aiden's birthday. Marshmallows for hot chocolate. Chocolates that Tim gave me. It's embarrassing how much is in there.
D&D was moved to tonight and I will put out everything in that cupboard that isn't for the kids (I'm not really tempted by their stuff) and keep one block of quality dark chocolate for myself. Anything not consumed will be thrown away. I can't have it in the house. I already ate some of the Doritos I bought for D&D when I found out it was postponed, I threw the rest away this morning because I didn't think an open packet would make it through the day.
I need to keep this level of panic. 11.0 might be a bit arbitrary for diagnosing diabetes, but at some point around that there is no going back. Prediabetes is reversable but diabetes isn't.
Another half an hour has passed and my blood glucose is 7.6 mmol/L, within normal limits. That's what high-GI means; a quick high then a quick drop.
later: I tested my blood glucose again after another half hour and it was down to 6, the bottom of the range (4-6 when fasting, like before breakfast, 6-8 two hours after meals). I should have had a snack. I didn't. I was just glad it was down. An hour and a half after that I was preparing dinner and I started to feel very odd, much like I did last week at gymnastics. I was trembling and it felt like my heart was racing. I felt very hungry, but dinner was only 15 mins away so that wasn't unusual. Then I started sweating heavily.
I went and checked my blood yet again. 3.9 mmol/L. I also, a bit later, checked the diabetes website. The definition of hypglycemic attack was under 4.0 and the early warning signs were:
*weakness, trembling or shaking
*feeling dizzy, light-headed
*sweating
*hunger
*tachycardia (racing heartbeat)
Four out of five. I was having a hypo. Presumably I did last week when I felt like this.
I had a chocolate biscuit and soon afterwards I had dinner. When I checked the website I found that chocolate is actually not so great because the fat in it makes it too slow-acting. Pure sugar, like soft drink or jelly beans, are better.
I am not a diabetic. I shouldn't be having hypos. Or peaks of 10.8 mmol/L. I am clearly getting worse.
Less than an hour after dinner I am back up to 8.2, a fraction too high but ok as long as it doesn't go higher. I am not getting this right. But I shouldn't have to be so careful. Very scary.
photo of blood glucose monitors by Bernard Farrell
Tuesday, November 13, 2012
Wednesday weigh-in: 77.6 kg
My weight is continuing to slowly creep downwards so that is great. If it takes me two or three years to lose 20 kg, well that is still better than not losing 20 kg! My scales have been less temperamental, too, since I started leaving them flat on the floor instead of leaning up on their edge. They only vary by a few hundred grams when I step off and on instead of up to a kg.
I'm feeling much better today and I think I have shaken off the cold germs. I've had a pretty good year, illness-wise, compared to the past. The last few years I've been sick a lot through autumn and winter but I think this year was much better.
I had my second (and probably last for me) diabetes/prediabetes seminar this morning. This one was all about healthy eating. It went into more detail about food than last week. Again it mainly covered things I was familiar with, but it gave me some concrete targets. As well as the general advice of less fat, more fibre, lots of fresh fruit and vegetables; I should aim for around 45 grams of carbohydrate at each meal and around 15 grams if I snack between meals. Low GI foods are preferred, and no sugary foods in isolation -- so I can't have a cup of tea with sugar by itself, only with food, otherwise I have to use artificial sweeteners or give up the sugar. Protein with each meal.
Another thing I learned is that peanut oil is good (ie monounsaturated) so I can use it for Asian cooking -- I don't have to always use olive oil.
Something I found really interesting was how resistant people are (and I include myself here) to hearing and/or accepting things that don't fit in with their current understanding or that they don't want to hear. One very obese lady said she had never been told to count carbohydrates before. I don't know how long she's had diabetes but it seemed unlikely as that has been used in diabetes management for a long time. She complained that she couldn't have yogurt anymore because it was full of sugar. The dietitian explained that actually that was mainly lactose from the milk and some fructose from the fruit and it was low GI and healthy. But it was clear the woman didn't believe her, and was going to continue to avoid yoghurt. One man (also morbidly obese -- so there may be a pattern there of the kind of person who doesn't take advice) seemed rather proud of the fact that he doesn't have breakfast in spite of all advice to the contrary. He also liked the idea of snacking all day rather than eating regular meals, and dismissed the dietitian's concern that that method could lead to overeating and calorie amnesia. No, no, that didn't apply to him. Um, sir? Your girth contradicts you.
In my own case, the thing about the sugar in my tea came up at the last session but I managed to dismiss it's importance. Such a little bit of sugar, I said to myself, it can't be that important. That rule somehow doesn't apply to me. But I have got it into my head now. The tiny splash of milk is not enough to bring down the high GI of the sugar, so I have to eat something low GI with my tea.
More Just Dance today, conquered two more songs. Twenty to go, so plenty more hours of exercise before I'm done. I don't just do the difficult ones, I took some time at the end of the session to do a couple of favourite songs and just enjoy them. The gardener arrived as I was finishing and was trimming some plants outside the lounge room window; he didn't look in but I felt a little embarrassed anyway. At least it made me put a little extra oomph in even though I was tired!
I saw an add for another fun run yesterday, a 5k this time around Lake Burley Griffin where I like to walk/run. My first thought was that I wanted to do it. But it is in a week and a half and I haven't even restarted my training, so I'm totally not ready. And it's on a hard surface, which hurts my shins. I could just walk a lot of it, of course. But the deal-breaker for me is that you have to wear a five piece Santa suit, including a beard, which they provide when you register. I may not have mentioned it much here, but I really really really hate being hot, especially when I exert myself at all. Even a brisk walk in jeans is unpleasant, and a sauna-like Santa suit would just be a nightmare. With a hat and a big beard? No way.
There will be other races.
photo of santa fun run by VarietyAU
Wednesday, October 17, 2012
The evils of salad dressing
After yesterday's rest I woke today all refreshed and ready to push myself! ... ah, actually no. I wanted to take another day off! My feet & legs weren't sore anymore, but it is that TOM and I just wanted to sit around and feel grumpy.
But it was a training day so I eventually managed to bully myself out the door. The schedule called for a 2.4 km steady slow run or brisk walk. There is no way I can run for 2.4 km so I decided on a brisk walk in a big loop of the suburb. To be honest, I bribed myself with a promise that I could stop at the corner store near the end and buy a little packet of Doritos and make nachos for lunch. A small serve, not too much cheese. Not healthy at all, but it got me out the door.
It was cool and cloudy this morning, it looked like it was going to pour down rain any minute, so I kept my jeans on instead of changing into gym shorts. Of course the moment I got out the door the sun broke though the clouds and it became quite warm. I got a bit hot in the jeans but it wasn't too bad -- after all I was just walking -- and after I got going I rather enjoyed my time outside.
When the little voice told me the workout was over I was about midway between the corner store and home, a couple of blocks each way. Strongly influenced by the fact that I really needed to pee, I ditched the idea of nachos and just went home.
Caesar salad! Excellent idea. A bit calorie laden, yes, but lots of crisp cos lettuce and a bit of salty bacon and a perfect soft-boiled egg... not too bad, right? I love Paul Newman's creamy Caesar salad dressing. I didn't read the nutritional label. Well actually, I did glance at it to check the carbs and they were very low so it seemed like a good choice, a fine choice. I didn't look at the calories. I meant to have one tablespoon. You know when you are trying to drizzle something out of a bottle and it goes nothing ... nothing ... nothing ... half the bottle? I scraped a lot off and even washed a few pieces of lettuce but still ended up with a lot more than I had planned. I guesstimated 2 tablespoons. And after lunch I plugged everything into CalorieKing.
A whole head of baby cos lettuce, excellent. Bacon; well I knew that would have calories, ok. Egg, fine. Bread, hmm should have had a bit less bread maybe. Oo, forgot the olive oil that I tossed the bread in to crisp it up. A few more calories there. And the 2 tablespoons of creamy dressing OH MY GOD 218 CALORIES!!!?
Yeah, not so good. 218 calories just for the dressing, on an already quite high-calorie lunch. Maybe I need to pre-track.
I mentioned that I got that email yesterday from Diabetes ACT saying I should manage carbs and watch my blood sugar levels, well last night was D&D supper. I didn't think I had too much; two TimTams (chocolate biscuits with chocolate cream enrobed in chocolate) and a few apricot delight (about 50% dried apricot and the other 50% probably sugar). A couple of hours later I was feeling kind of light-headed. Could have been just tired and I have no idea if high blood sugar has a dizzying effect, but I went and tested my blood. 10.4 mmol/L, which I think is the highest I've ever seen it. Higher even than during the glucose test after 75 g of carbs!
I've calculated around 45g of carbohydrate, mainly sugar. Did it go up so high because it was a different time of day to the fasting test? Or because I had supper only about two hours after dinner? Or because I tested a bit less than 2 hours after starting to eat supper (about 1 hr 45 mins) instead of exactly 2 hours?
Or am I getting worse already?
Now there is a scary thought.
It is two months since my glucose tolerance test. I haven't lost any weight -- I've crept up by nearly a kg. I have good intentions every day and fail to follow through. This is so important.
I called Diabetes ACT and I've organised to go along to a couple of information sessions soon. I hope that will be of some help. But I know what I need to do, and it's me that needs to do it, not them. What will it take to make me take this seriously enough to be consistent?
This is it. I am serious. Now.
Tuesday, October 16, 2012
Wednesday weigh-in: 78.6 kg
Wednesday:
My weight has been hovering between 78 and 79 kg for a few weeks now, no change there.
The soles of my feet were still a bit sore this morning. One friend suggested that I get some extra padding for inside my running shoes, my husband thinks I probably just have to toughen them up a bit. Maybe both? I'll get some inserts, and more pairs of wicking socks, and try to build up foot stamina. I used to get sore feet after about 3 or 4 km, now I'm up to 7 or 8 before the soles start to feel abraded.
My legs were also very sore (in a good way, like I'd worked the muscles hard) so I decided to have a rest day. Just half an hour of walking. And I had plenty of non-exercise things to catch up on. It's kind of funny/sad to think that three days of two hours a day is enough to exhaust me. I've had 22 hours a day when I'm not exercising to rest. Nevertheless. That is my level of fitness right now.
So I read and rated six short stories that had been submitted for publication, reviewed one book that I read a while ago, finished filing away papers from when we did our tax return on the weekend, folded some of the mountains of laundry etc.
I had written to Diabetes ACT (my state - stands for Australian Capital Territory) about whether or not I had to count carbohydrates, since my doctor didn't bring it up and my dietician friend said I didn't need to since I wasn't injecting insulin. I wasn't sure though; if I was diabetic I would have to but why not for a pre-diabetic? Today I got a response that recommended I do.
"Slightly increased blood glucose levels will not cause the micro- and macro vascular complications seen in diabetes, but it stimulates excess insulin secretion that can contribute to the development of type 2 diabetes."
Good to get that cleared up. I am going to go to an "Introduction to prediabetes" information session they are holding in a couple of weeks.
I've been making a better effort at tracking the past few days. So many things to work on.
My weight has been hovering between 78 and 79 kg for a few weeks now, no change there.
The soles of my feet were still a bit sore this morning. One friend suggested that I get some extra padding for inside my running shoes, my husband thinks I probably just have to toughen them up a bit. Maybe both? I'll get some inserts, and more pairs of wicking socks, and try to build up foot stamina. I used to get sore feet after about 3 or 4 km, now I'm up to 7 or 8 before the soles start to feel abraded.
My legs were also very sore (in a good way, like I'd worked the muscles hard) so I decided to have a rest day. Just half an hour of walking. And I had plenty of non-exercise things to catch up on. It's kind of funny/sad to think that three days of two hours a day is enough to exhaust me. I've had 22 hours a day when I'm not exercising to rest. Nevertheless. That is my level of fitness right now.
So I read and rated six short stories that had been submitted for publication, reviewed one book that I read a while ago, finished filing away papers from when we did our tax return on the weekend, folded some of the mountains of laundry etc.
I had written to Diabetes ACT (my state - stands for Australian Capital Territory) about whether or not I had to count carbohydrates, since my doctor didn't bring it up and my dietician friend said I didn't need to since I wasn't injecting insulin. I wasn't sure though; if I was diabetic I would have to but why not for a pre-diabetic? Today I got a response that recommended I do.
"Slightly increased blood glucose levels will not cause the micro- and macro vascular complications seen in diabetes, but it stimulates excess insulin secretion that can contribute to the development of type 2 diabetes."
Good to get that cleared up. I am going to go to an "Introduction to prediabetes" information session they are holding in a couple of weeks.
I've been making a better effort at tracking the past few days. So many things to work on.
Friday, September 21, 2012
Carbohydrate counting
Saturday:
When I found out I was pre-diabetic (or actually before the official diagnosis, because I strongly suspected I was) I started moderating carbohydrates. Not because carbs are in any way the enemy, but because a large carbohydrate load all at once can cause blood sugar levels to go up in someone (like me) who has glucose intolerance. I found that, for me, up to about 3 serves of carbs at a time (1 serve = 15 grams of carbs, like 1 slice of bread) was fine but more made my blood sugar go too high.
Books about diabetes talked about the dangers of blood sugars going too high; but, confusingly, the information for pre-diabetics doesn't seem to mention it at all. Why not? When I finally got to see my doctor, she didn't mention it either. It's all about the losing weight and exercising to avoid getting full-blown diabetes, nothing about managing it along the way. When I said I was being careful with carbs she agreed that was a good idea but certainly didn't devote any time to the subject. And my nutritionist friend said I didn't need to count carbs unless I was taking insulin -- but that would be to insure my blood sugar didn't go too low, wouldn't it?
This morning I had 4 serves of carbs for breakfast. I tested my blood later and my glucose (sugar) level was up to 9.3 mmol/L. In what sense is this ok? Maybe it's not as high as a diabetic's glucose levels might go, so maybe it's not doing as much damage as if it was 16 or something. But it is still over the normal, safe level which I believe to be 7.8 mmol/L. The difference between being pre-diabetic and diabetic is just being a little further up a sliding scale; it isn't really a yes or no it is just a point at which the researchers decided it was bad enough to be called diabetes. So, as far as I can tell, it's not like something that is bad when you are a little bit further along isn't bad if you aren't quite there.
I think I need to talk to an expert, maybe contact the Diabetes Australia or Diabetes ACT people and ask some questions.
When I found out I was pre-diabetic (or actually before the official diagnosis, because I strongly suspected I was) I started moderating carbohydrates. Not because carbs are in any way the enemy, but because a large carbohydrate load all at once can cause blood sugar levels to go up in someone (like me) who has glucose intolerance. I found that, for me, up to about 3 serves of carbs at a time (1 serve = 15 grams of carbs, like 1 slice of bread) was fine but more made my blood sugar go too high.
Books about diabetes talked about the dangers of blood sugars going too high; but, confusingly, the information for pre-diabetics doesn't seem to mention it at all. Why not? When I finally got to see my doctor, she didn't mention it either. It's all about the losing weight and exercising to avoid getting full-blown diabetes, nothing about managing it along the way. When I said I was being careful with carbs she agreed that was a good idea but certainly didn't devote any time to the subject. And my nutritionist friend said I didn't need to count carbs unless I was taking insulin -- but that would be to insure my blood sugar didn't go too low, wouldn't it?
This morning I had 4 serves of carbs for breakfast. I tested my blood later and my glucose (sugar) level was up to 9.3 mmol/L. In what sense is this ok? Maybe it's not as high as a diabetic's glucose levels might go, so maybe it's not doing as much damage as if it was 16 or something. But it is still over the normal, safe level which I believe to be 7.8 mmol/L. The difference between being pre-diabetic and diabetic is just being a little further up a sliding scale; it isn't really a yes or no it is just a point at which the researchers decided it was bad enough to be called diabetes. So, as far as I can tell, it's not like something that is bad when you are a little bit further along isn't bad if you aren't quite there.
I think I need to talk to an expert, maybe contact the Diabetes Australia or Diabetes ACT people and ask some questions.
Sunday, September 2, 2012
Brief review of some books about diabetes
I have read quite a few books but have returned some of them to the library already, this is not meant as a comprehensive review of the literature. Just some thoughts.
Prediabetes for Dummies (already returned so I don't have publishing details handy)
I hate hate hate the title of this book -- part of a big franchise of "for Dummies" books -- and would never have bought it just because of that. But it didn't seem to be geared to dummies at all. It had plenty of comprehensive information about prediabetes and in fact was one of the very few I could find that was about prediabetes rather than diabetes. Written by a medical professional and strongly pushing the "lose weight and exercise" message, it also went into detail about what is happening in the prediabetic body. Recommended.
Various CSIRO books about Diabetes (already returned)
CSIRO stands for ... um ... something or other, anyway they are Australian science boffins. I tried their diet last year or the year before (it was a best seller) and wrote about it here in the blog. The books with the word "diabetes" on the cover had some information about diabetes but mainly just pushed their diet. Lots of recipes and glossy pictures of happy healthy people. An attractive couple of books but didn't have any depth of information so not really what I was looking for.
The First Year: Type 2 Diabetes by Gretchen Becker
Marlowe & Company: 2004
This book is written by someone with diabetes rather than a doctor or scientist, and I loved it. A very easy to read, chatty and informal style from someone who has been through it all; but with lots of detailed information too. As well as the physical aspects, she talks about emotional aspects like depression and having to watch other people eat cake. There were some "facts" there that I hadn't seen elsewhere (therefore unsubstantiated and under suspicion but still interesting). It had its faults, in particular she talks about lots of different studies but doesn't reference them in the text, so you don't know which of the studies in the Resources chapter she is referring to. On the other hand, she seems to give a very balanced approach to different arguments, saying that no one size fits all and every situation is different. Recommended.
Prediabetes for Dummies (already returned so I don't have publishing details handy)
I hate hate hate the title of this book -- part of a big franchise of "for Dummies" books -- and would never have bought it just because of that. But it didn't seem to be geared to dummies at all. It had plenty of comprehensive information about prediabetes and in fact was one of the very few I could find that was about prediabetes rather than diabetes. Written by a medical professional and strongly pushing the "lose weight and exercise" message, it also went into detail about what is happening in the prediabetic body. Recommended.
Various CSIRO books about Diabetes (already returned)
CSIRO stands for ... um ... something or other, anyway they are Australian science boffins. I tried their diet last year or the year before (it was a best seller) and wrote about it here in the blog. The books with the word "diabetes" on the cover had some information about diabetes but mainly just pushed their diet. Lots of recipes and glossy pictures of happy healthy people. An attractive couple of books but didn't have any depth of information so not really what I was looking for.
The First Year: Type 2 Diabetes by Gretchen Becker
Marlowe & Company: 2004
This book is written by someone with diabetes rather than a doctor or scientist, and I loved it. A very easy to read, chatty and informal style from someone who has been through it all; but with lots of detailed information too. As well as the physical aspects, she talks about emotional aspects like depression and having to watch other people eat cake. There were some "facts" there that I hadn't seen elsewhere (therefore unsubstantiated and under suspicion but still interesting). It had its faults, in particular she talks about lots of different studies but doesn't reference them in the text, so you don't know which of the studies in the Resources chapter she is referring to. On the other hand, she seems to give a very balanced approach to different arguments, saying that no one size fits all and every situation is different. Recommended.
Wednesday, August 29, 2012
Visiting the doctor
Thursday:
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.
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.
Monday, August 20, 2012
What I have learned about Prediabetes
Tuesday:
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.
So:
# 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.
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.
So:
# 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.
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