Pre-diabetic diet - help!

Watching with interest 

my hba1c has shot up from 33 to 39 in a year so I’m right on borderline. Need to make some changes in the The new year. Definitely feel ready meals for 20 years has been a factor 

invested in one of those libre things earlier in year for a month and it was shocking seeing how high my numbers went, although they did come down within the expected time

Can I ask out of interest, do you snack every day and what do you usually snack on?

My first thing to try would be to eliminate all sugary snacks, and just eat fruit as a snack on special occations (ie if you need something after a ride).

I tend to skip breakfast, eat a salad and tuna lunch and then a more normal, but sometimes unhealthy dinner. My problem is the snacking, which I am working on!

Berries are probably better than fruit 👍

ahem, tick

Also watching with interest:   Back in March I had a tia, and consequently a whole raft of tests.

my hbac level back in march was 36. I gave up a lot of culinary pleasures:  Beer, butter, bread, bacon, caffeine,  sugar, salt and wine, and although I had what I thought of as a healthy diet, made it more healthy- plenty of greens and far fewer root vegies.

In the next 3 months I lost 12kg and felt so much better! So when a 3 month follow up blood test showed my hbac had soared to 41 (diabetic is 45+) I was a bit miffed. So I gave up bananas too.

Still feel great, still 12kg lighter, and waiting for another follow up test after Christmas.

Good luck OP, you're not alone...

Berries definitely better than fruit.

I know a lot on here won't agree but drop starchy carbs, pasta, bread, cereals and rice.

Eat vegetables that grow above ground with good quality protein, tuna, chicken etc.

I’ve spoken to people in the past who’ve been in a similar situation and swear by the Roy Taylor Newcastle plan. <br /><br />

https://amp.theguardian.com/society/2021/may/15/how-to-cure-type-2-diabetes-without-medication

From what I gather it’s not the easiest thing to start with but it works very well. 

I was diagnosed Type 2 diabetic with an hba1c of 60 following COVID, family has a genetic disposition it seems for T2 following illness, but usually appears with cancer.
I managed to get it down to 37 in 3 months following a decent diet and exercise.
Firstly when it comes to exercise, even a decent paced walk is good for reducing blood glucose levels, weight training is excellent as the more lean muscle mass you have, the more those muscles will pull glucose from the blood stream
Some of the best advice you will read is towards bottom of this Torq page about causes and ways to fight T2
https://www.torqfitness.co.uk/product-category/nutrition/diabetes-products
What you will see is loads of people touting very low carb and keto diets, but if you read the above, you will appreciate why saturated fat is just as bad for you as simple carbs.
You also need to understand that the cause of T2 and pre-diabetes is "insulin resistance", but that this resistance is a movable line, the better your diet, the more you exercise, the more lean muscle mass you have, the less stress and the more sleep you have, the better your insulin uptake, and its conversion of blood glucose into "energy" will be.
Poor diet, long periods of inactivity, poor sleep and stress, all make the matter worse.
What you are wanting to do is have carbs that are low GI, so their absorption into the bloodstream is slow, insulin takes about 40-60 minutes to really start working, so if you high GI carbs or simple sugars, it is getting into blood stream quickly and cause a "spike" in blood glucose before the insulin can act. Slow that absorption and it has time to do its job.
The main thing is to try and have quality protein, fats and fibre with every meal. If you have these, then they slow the carbs you have going into the bloodstream. So a slice of white toast with marmalade on is nearly all simple high GI carbs, and will cause a spike. A slice of quality granary or sourdough bread with an egg or avocado on top, has a good mix of fat, protein, fibre and better quality carbs, and will not cause a spike.
Think of your stomach like a sieve and your bloodstream a bucket below, eat simple processed carbs and nothing with them and it is like water flowing straight through the sieve. Line that "sieve" with fats, protein and fibre, and the water  (carbs) cannot flow through anywhere near as quick
There are also a few tactics you can use that have fashionable wording, but work:
- Food pairing - Are you eating something that may cause you a spike, for example a piece of fruit, then pair it with something with fibre/fat/ protein, so for example, i will have a handful of nuts before i eat an apple, I will have an apple with a few scoops of peanut butter, or a decent portion of greek yoghurt with blueberries on top.
- Carbs timing - Don't be eat a carb rich meal when you know you are about to be sat at a desk for the next 5 hours, the time to eat those carbs is 60-90 minutes before you know you are going to exercise or go for a decent walk
- Food order - If you know you are about to treat yourself to a roast dinner, or similar, it is a bit childlike, but eat your meat and fibrous veg first, so they line the stomach, then the more carby stuff last.
Things i have as staples in kitchen, sourdough bread, peanut butter, eggs, greek yogurt or those low carb/high protein ones made with quark, apples, berries, lots of green veg, brown rice, lentil pasta etc
Final thing, stay hydrated, being dehydrated will cause BG levels to rise.

You will hear a lot of "carbs are the enemy" advice, but the brain needs about 150g of carbs a day to function, and you can take in low-GI carbs if you follow the rules above.

I think i have blathered on enough, but feel free to PM me if any questions, Diabetes UK website is good for advice and their are some very good pages on Instagram (amongst very many, very bad american ones)

I know a lot on here won’t agree but drop starchy carbs, pasta, bread, cereals and rice.

I've a patient at my practice who's more than a bit evangelical about this diet and will button hole any one and everyone about its benefits, and TBF to him he's lost a tremendous amount of weight (like; 40kgs worth). and it's done wonders for his diabetes. On the other hand some find that diet both massively restricting and hard to stick to long term...and the evidence for it isn't as conclusive as some would like it to be.

OP: try to avoid as many processed foods as you can, cook meals for yourself,  make enough for lunch the following day (or make your lunch at home), try not to snack, cut down your portion size. Good luck! For lots of the time, you need to be hungry, it's normal, and OK, you don't need to eat just becasue of kuchisabishii

The issue is that a very low carb diet, like any diet will cause weight loss, and if you testing your fasting blood glucose levels, may give good scores.

But if you don't have a healthy diet, and you follow one of these keto or similar diets with a lot of saturated fat, then you are masking the problem, not addressing it.

Whilst using my libre sensor I was very conscious of what I ate. The blood sugar numbers were good, but I really struggled to maintain weight. I eat a lot of pasta, and in 3 weeks I lost about 3kg. Which would be good if I was overweight, but not so good when I felt I was at the ideal weight already. And I was constantly hungry

diabetic is 45+)

in the uk it’s 48..

Told me that I'm prediabetic too. I exercise a lot and don't eat sweet things.
My dad got diabetes at 92 and still seems fine.

I know a lot on here won’t agree but drop starchy carbs, pasta, bread, cereals and rice

+1. And potatoes. Use the above to fuel training, and heavily limit it in other circumstances. (Eg oats+peanut butter before a ride cereal bars every hour is FINE and of course needed)

Loads of varied vegetables and healthy meats, cooked healthily. + nuts, quality cheeses, seeds, etc. Just proper, actual, colourful food.

Probably in less portions than you're used to (We eat WAY too much these days). The goal is to be healthy.

Look into the science of how beneficial intermittent fasting is for blood sugar regulation etc, and draw your own conclusions.

Classification in this country is on hba1c, this is basically a snapshot of your blood glucose levels for the last 3 months (Lifetime of a red blood cell), below 40 fine, 40-48 is pre-diabetic, over 48 diabetic.

You also have to remember some of the implications of not-controlling it, if you're diabetic you need to inform DVLA and car insurers, travel insurance can be a pain etc, that's before you get to the actual long term health issues.

Whilst using my libre sensor I was very conscious of what I ate

+1 to that; I'm T2, fairly skinny these days (lost about 6-10 kilos by cutting out choc & sweets when first told I was out of range 😳 ) and do a decent amount of exercise.  Still glucose runs high and they think I'm quite possibly one of these MODY types, though a limited genetic test showed nothing abnormal in tems of the "common" type.

I bought a couple of sensors and they gave me a really good idea of what foods did what, though I still only managed one day of completely normal range and that was with an almost totally meat'n'egg intake.  I'm going to repeat soon to see if anything has changed (I reckon my behaviour has regressed a little bit)

I'm type 2, my hba1c was 138, got it down to 46 in three months, although they think I've lost about 50% of my insulin production so I'm on all the metformin in the world.

There's good advice above but in very simple terms try to avoid sugary foods and white processed carbs, the thing that really spikes my sugars isn't actually sugary food ( in moderate amounts) it's white carbs, especially white bread, if I eat a baguette my blood sugar rockets, so I just don't. Switch to brown/wholemeal carbs and try to keep them down to a reasonable amount.

The best thing you can do is walk for ten to fifteen minutes after food, it's amazing how much walking drops your blood sugar.

I am not pre-diabetic but I specifically do bikes rides without eating anything before leaving the house to improve my insulin sensitivity, and it does seem to have an effect.

https://type2diabetes.com/living/exercise-before-breakfast

Thanks all, lots of, erm, food for thought!

I'm terrible at snacking and also massive portions etc.

@scud some great info in those posts.  I'm glad I'm aware if it now and can sort it out.

It's funny how people have reacted when I've told them, I think everyone has a certain image associated with Type 2 diabetes, I'm probably guilty of that as well, and can't get their head around an active cyclist having a problem...

I think everyone has a certain image associated with Type 2 diabetes, I’m probably guilty of that as well, and can’t get their head around an active cyclist having a problem…

Including my GP! When I once mentioned to him that I wanted to minimise the risks of developing type 2 he immediately responded by confidently informing me that I wouldn't become diabetic.

Somewhat taken aback I enquired how could he be so sure, he claimed that all his patients who had developed type 2 were overweight couch potatoes. He reckoned that all my cycling would protect me. Nice thought but I remain unconvinced. Although hopefully it does minimise the risks.

Reading this with interest. I came out of COVID as pre-diabetic. Slipped above 48, and have gone lower since. But it's crept back up and the diabetes nurse told me that insulin production reduces with age... So it'll get worse.

Bread is my kryptonite! I struggle massively with snacking on carbs. 3 kids means we have lots of tempting garbage kicking around the house. Lunch tends to be beans as I'm often short of time trying to fit in a job book ended by the school runs.

But I will try having breakfast before the morning school run now, as it's a 25m walk and I can see that helping.

There's a genetic element to T2D that's complex (I certainly don't understand it entirely) but it comes down to essentially keeping the weight off as an adult.

Where that weight limit is for you can differ wildly from where it is for some-one else though, which is why there's a bunch of folks who though don't "look the sort" have breached the level at which their bodies can safely store fat under the skin, and it's beginning to effect the function of their liver and other organs, and they're developing T2D. Rapid weight loss has been shown reverse T2 at the early stages though, so if you are older, and piling on the weight, or you're suddenly thirsty all all the time, don't hang about.

Not all type 2's are overweight, when I was sat in the doctors surgery with blood sugars of 138 I'd just lost two stone in two months and was losing 3-4lbs a week as my body was basically starving itself, this is because your kidneys just make you pee out the sugar in your blood constantly, hence you're not converting any of your food in to usable energy, I wasn't overweight before that but I was down to zero body fat and I'd lost loads of muscle too, I couldn't sit on a chair without a cushion as I was straight on to my bones, it was actually quite scary as it seemed both uncontrolled and uncontrollable.

Type 2 brought on by lifestyle is only relevant for around 85% of people, there are lots of factors that can make you insulin resistant as well as have poor insulin production, unfortunately lots of them are hereditary.

Like many others mine coincided with a bad bout of Covid and seemed to come on overnight, whether or not it was connected who can say, there seems to be a narrative that a strong viral infection can often be a trigger but I think the jury is still out on that one.

Funny how three of us mention it coming from COVID, when i was diagnosed with it 2 years ago following COVID< the doctors thought i was joking and wouldn't take that seriously.

Then got told i was overweight as i have a high BMI (very much an old rugby lad) but then proved to them i had a lower body fat than the doctor telling me i was overweight and that the week before i had ridden mountain bike 198 miles in 26 hours when he kept telling me i needed to exercise more! 

Trouble is it is looked upon very much as a disease of the "sweet munching sedentary chubster", down to it being the  punchline from many a comedian to make a fat joke, a doctors can be very dismissive and there is so much contradictory evidence.

I found this book very good:

https://www.amazon.co.uk/Diabetic-Muscle-Fitness-Guide/dp/0995762201/ref=sr_1_1?adgrpid=103679070665&hvadid=592973363938&hvdev=c&hvlocphy=9045079&hvnetw=g&hvqmt=e&hvrand=9338774680791211074&hvtargid=kwd-926965596879&hydadcr=22555_2214463&keywords=the+diabetic+muscle+and+fitness&qid=1702034596&sr=8-1

And I was constantly hungry

The diet industry - which lets face it is a food marketing industry - has made 'feeling hungry' some sort of bugbear. "you need to eat less but what if you feel hungry? Hunger might spring upon you and you'll be ill-prepared - guard against that by buying this conveniently packaged food and keep it about you at all times"

Hunger (rather than starvation) is just a sensation - the sensation of not currently digesting food. Its not painful, its not unpleasant, its not a problem you need to solve, its not a distraction its just one of a range of sensations.

I’ve already cut down on snacking by drinking more water, and replacing chocolate with fruit.

How about instead of replacing sugar with sugar when your not even eating a meal by replacing chocolate and fruit with nothing.

Being aware that you are hungry is OK

I plan to publish a best selling diet book with that title for the lucrative post chistmas fad diet market - struggling with the word count though. So far Ive got the title but sort of running out of steam now.

The covid thing is interesting, I caught it about three weeks before I had a blood test, though this time round I felt fine.  Last year I was struggling post covid for about three months with a lack of energy and excercise wiping me out for days.

@maccruiskeen this is a fair comment, but in the past my energy levels dip alarmingly if I go too long without fuel in the tank, I know this is most likely linked, but have always shrugged it off.   I'm possibly going to go without breakfast when I ride to work, and have a handleful of nuts and one piece of fruit when I get to my desk instead.  Seems to have worked this morning, and I haven't got hangry 🙂

What I really don't want to do is drop weight, after 47years I'm finally at peace with my body, maybe I need to add more strength training into the mix to balance any potential weight loss...

@maccruiskeen - I don't think you understand the "always feeling hungry" comment for a newly diagnosed diabetic, I am Type2, but daughter is Type1, on diagnosis you are literally being starved, my daughter would eat and eat, but was losing weight rapidly, essentially  without insulin, which the body uses in the process to convert food to energy, you can eat all you like, but your body is deriving no energy from it, so you feel terrible lethargy, constantly hungry and if left unchecked, then you can into diabetic ketoacidosis and a coma.

So it nothing to do with not being able to control yourself and ignoring your hunger...

On the flip side as the parent of a teenage type 1 girl, who is very self conscious and loves fashion, we do not look forward to the day when she may twig that dia-bulimia is a thing, and all you need to do to keep your weight down is to give yourself too much insulin..

One thing that isn't widely reported is that being insulin resistant can very often lead to weight gain as the body just keeps producing more and more insulin to solve the problem and inevitably leads to overproduction, causing insulin spikes leading to sugar lows and hunger spikes, thus many who are insulin resistant are hungry all the time, thus overeating and gaining weight, which further exacerbates the problem, hunger isn't just triggered by an empty stomach, it's also triggered by low blood sugar levels.

This overproduction of insulin can often lead to pancreatic beta cells closing down ( I'm oversimplifying they actually revert to their base stem cell form) and then loss of insulin production, which is why some type 2s end up injecting insulin, thus end up in the same boat as type 1 but via very different causes.

https://lowcarbfreshwell.com/

Growing evidence for a low carb lifestyle to reverse type 2 diabetes, the link above has information around the science, what to eat, when to eat, and so on

“The Freshwell Low Carb Project is an initiative set up by Dr David Oliver and Dr Kim Andrews at the Freshwell Health Centre, Essex, UK. This project grew out of our concern about the rise in incidence of type 2 diabetes over the last few years, alongside the widely reported rapid increase in obesity in the UK population”

I first came across this from the following article where a patient told their doctor off

https://amp.theguardian.com/society/2023/apr/09/british-doctor-pioneers-low-carb-diet-as-cure-for-obesity-and-type-2-diabetes

So slight thread resurrection after having just had my first annual diabetic review with the diabetic nurse.

I asked her about the mechanics of why my type 2 came on so suddenly and with such extraordinarily high blood sugars ( hba1c of 138, the phrase extraordinarily high were her words not mine) and her answer was that it was almost certainly triggered by my having Covid as they were seeing it again and again during the pandemic where people were coming in with type 2 and very high blood sugars after a bad bout of Covid, apparently strong viral infections are known to trigger diabetes and Covid is no different.

Food for thought.

@Catfood, interested that you have come back with that, my doctors at the time laughed when i suggested the link, I had a few issues with fatigue in the year running up to COVID, and they tested BG levels and had always been below 39, there is a genetic history of Type 2 following illness with mum and others getting after cancer.

In the weeks after COVID i noticed need to pee 3 times a night, fatigue and eyesight was starting to get blurry, and they just passed off as COVID symptoms, it is only because my daughter is T1 and i recognised symptoms, i pressed them for hba1c test. Even then I got no advice, was just passed a book, internet course to sign up for and told i'd need metformin, i asked not to placed on drugs as yet and to see if i could reduced to safe levels with diet and exercise, but they refused to believe the T2 and COVID were linked at the time.

She said she was the one at the practice that noticed it ( hardly surprising) and it was only because of the regularity of it occurring that they thought there was definitely a link, apparently this has been confirmed as happening regularly elsewhere but as she said it takes time to establish a causal link, medically that is.

I suspected there was a link as it happened simultaneously but obviously couldn't and can't be certain but at least it fills in some of the gaps in my knowledge and I have a better handle on what has probably happened to me.

Another one here with Type 2 out of nowhere, i got send to hospital by my GP and first thing they asked was if i had had covid as they had begun to see a possible link.

There was another guy waiting in hospital with me and it was same thing with him, his was so bad they admitted him. 

My test was 96, i got that down to normal in around 4 months by cutting all crap from ny diet.  2 years later i dont really have to think about what i eat as long as i get enough exercise.

Type 2 runs in my Dads side of my family, where clearly I get most of my physical attributes from so I’m very aware of this. My Dad has largely kept his levels down below 40 since becoming type 2 15 years ago, following the guidance scud outlined. Good advice. 

pre-diabetic here as well
I do about 3 or 4 yoga / Pilates classes a week, does that count as strength training or do I need to add in a couple of weights sessions on top of that?