Pre-diabetic, questions and concerns. Can anyone help?
LadyLilion
Posts: 276 Member
Hi all. I hope someone can give me some information.
I have not been diagnosed as diabetic, only “pre-diabetic”, but frankly I’m thinking of changing doctors. My old doctor retired and I really don’t like my current one as she seems only interested in treating things like colds and sprains and not really worrying about general health. In 2016, my a1c was 6. In March 2017, it was 6.5. She put me on Metformin, 500 mg 1 x per day, which I take at night. I haven’t bothered with the taking it with meals since I always forget and I have had no stomach upset at all, so I just take it with other meds. 4 months later, I was back to 6 and she was pleased. However, my fasting blood sugar was over 140! It had been 126 or so the time before that! My husband (a1c of 7) was diagnosed as diabetic and given a meter, so I’ve used his a time or two and my fasting blood sugar is always over 130. For instance, this morning, about an hour after I got up, and with no food, it was 136.
The fasting blood sugar being so high has me quite concerned. Since I don’t have a meter or test strips of my own, I haven’t been taking it regularly so he doesn’t run out. He's only had his meter a couple weeks, so I've only tested a few times. But…he’s the one with diabetes, yet my sugar is always higher than his. Literally every time we’ve tested at the same time, I’m higher.
I guess, I’m wondering if my doctor is a quack. Maybe I should get a second opinion. It’s not that I’m hoping to be fully diabetic – but shouldn’t I be doing something differently if I am? I've been given no real instructions, just a pill. I mention that I've lost weight and I get
"That's nice."
No input, no diet suggestions, no prescription for testing supplies, no...anything.
Should probably add, I’m 53, 5’10” and currently 288 lbs. March 5, when we got serious about improving our health, I was at 306…so on the way down. No diabetes in my family. I have a VERY sedentary job, which has been a challenge, but I'm working on getting more steps in. I see a dietician once a month and she’s set my MFP calories at 1900 (about to lower that, but 1900 has gotten me right at 1 lb a week loss) and 45% carbs, 25% protein and 30% fat. I usually stay under on carbs…not so good with the others. I take a TON of pills. Lipitor for cholesterol, THREE BP pills – my BP is hard to control, at my thinnest – 228 a few years ago, I was down to 2, but as I gained back what I'd lost, the 3rd pill had to be put back on. I have a heart murmur and arrhythmia too but neither bother me at all. Everyone in my family who is dead has died of heart disease…almost literally everyone. I had a cardiologist, but he released me a couple years ago as I was doing just fine.
You know, I don’t even know what I’m asking here…I just saw that 136 this morning – again – and it kind of freaked me out when I realized that is a high fasting blood sugar even for a diabetic.
Words of wisdom? Suggestions? Information? I searched groups - but there doesn't seem to be one geared at diabetics...
I have not been diagnosed as diabetic, only “pre-diabetic”, but frankly I’m thinking of changing doctors. My old doctor retired and I really don’t like my current one as she seems only interested in treating things like colds and sprains and not really worrying about general health. In 2016, my a1c was 6. In March 2017, it was 6.5. She put me on Metformin, 500 mg 1 x per day, which I take at night. I haven’t bothered with the taking it with meals since I always forget and I have had no stomach upset at all, so I just take it with other meds. 4 months later, I was back to 6 and she was pleased. However, my fasting blood sugar was over 140! It had been 126 or so the time before that! My husband (a1c of 7) was diagnosed as diabetic and given a meter, so I’ve used his a time or two and my fasting blood sugar is always over 130. For instance, this morning, about an hour after I got up, and with no food, it was 136.
The fasting blood sugar being so high has me quite concerned. Since I don’t have a meter or test strips of my own, I haven’t been taking it regularly so he doesn’t run out. He's only had his meter a couple weeks, so I've only tested a few times. But…he’s the one with diabetes, yet my sugar is always higher than his. Literally every time we’ve tested at the same time, I’m higher.
I guess, I’m wondering if my doctor is a quack. Maybe I should get a second opinion. It’s not that I’m hoping to be fully diabetic – but shouldn’t I be doing something differently if I am? I've been given no real instructions, just a pill. I mention that I've lost weight and I get
"That's nice."No input, no diet suggestions, no prescription for testing supplies, no...anything.
Should probably add, I’m 53, 5’10” and currently 288 lbs. March 5, when we got serious about improving our health, I was at 306…so on the way down. No diabetes in my family. I have a VERY sedentary job, which has been a challenge, but I'm working on getting more steps in. I see a dietician once a month and she’s set my MFP calories at 1900 (about to lower that, but 1900 has gotten me right at 1 lb a week loss) and 45% carbs, 25% protein and 30% fat. I usually stay under on carbs…not so good with the others. I take a TON of pills. Lipitor for cholesterol, THREE BP pills – my BP is hard to control, at my thinnest – 228 a few years ago, I was down to 2, but as I gained back what I'd lost, the 3rd pill had to be put back on. I have a heart murmur and arrhythmia too but neither bother me at all. Everyone in my family who is dead has died of heart disease…almost literally everyone. I had a cardiologist, but he released me a couple years ago as I was doing just fine.
You know, I don’t even know what I’m asking here…I just saw that 136 this morning – again – and it kind of freaked me out when I realized that is a high fasting blood sugar even for a diabetic.
Words of wisdom? Suggestions? Information? I searched groups - but there doesn't seem to be one geared at diabetics...
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Replies
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First, congrats on losing 18 pounds! That's awesome!
I don't have much knowledge on the medical front, but it sounds like your doctor is kind of "checked out". I think changing doctors would be a good idea. You shouldn't have to put up with a doctor who makes you feel abandoned.4 -
by doctor - are you talking primary care or endocrinologist?0
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Thanks for responding. Primary Care physician, not specialist. I'd need a referral to see an endocrinologist and I frankly don't think my doctor cares enough to bother. She isn't bad, she's just...cold. I don't expect my primary care doctor to be my buddy...but I'd think they'd care about a little thing like your overall health.0
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Along with checking into the doctor idea- I am in the process of reading the 8 week blood sugar diet by micheal mosley- it has some good information. I am not diabetic either however my mom is pre-diabetic and my whole family has diabetes in many family members- think about getting a copy of this book- or at least go to youtube and look it up- I will not eat exactly but it will help with the tweaks to be made in our diet- also since you do not eat a lot of sugary carbs- you will probably do really well on it.1
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depending on your insurance, you may not need a referral (I know I don't)0
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I am not a doctor, but I would 100% agree that your fasting blood sugar readings are way too high, and consistent with full-blown diabetes. You should get in to see someone ASAP. Bring clear documentation of the blood sugar readings you have taken, as well as some info from the internet such as from the ADA website. It's very clear that with a fasting blood sugar reading over 126, you are considered to be diabetic. You need treatment because high blood sugar is very damaging to the body. Go be your own advocate, and don't accept no for an answer! Good luck!1
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deannalfisher wrote: »depending on your insurance, you may not need a referral (I know I don't)
Is there a real benefit to seeing an endocrinologist vs. a "regular" doctor early on?Along with checking into the doctor idea- I am in the process of reading the 8 week blood sugar diet by micheal mosley- it has some good information. I am not diabetic either however my mom is pre-diabetic and my whole family has diabetes in many family members- think about getting a copy of this book- or at least go to youtube and look it up- I will not eat exactly but it will help with the tweaks to be made in our diet- also since you do not eat a lot of sugary carbs- you will probably do really well on it.
I'll have to look that up. Thanks!0 -
LadyLilion wrote: »Thanks for responding. Primary Care physician, not specialist. I'd need a referral to see an endocrinologist and I frankly don't think my doctor cares enough to bother. She isn't bad, she's just...cold. I don't expect my primary care doctor to be my buddy...but I'd think they'd care about a little thing like your overall health.
I had a PCP like that once. She was so cold, and shrugged off problems I was having. I left that practice real quick. I learned a long time ago that you need to be an advocate for yourself with your doctors. With a previous doctor, I had so many bad symptoms that this doc just kept saying it was nothing and wouldn't investigate. About 4 months after my first complaint, I was in the ER being told by 3 doctors that I had a huge tumor in my chest.
Never again will I have a doctor who is dismissive and cold. Ever.4 -
an endocrinologist specializes in diseases like diabetes, thyroid conditions - so tends to be (although not always) - more in sync with current research/guidelines for treatment etc1
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My husband quite likes his doctor who is much more holistic in her approach, for lack of a better term. When he started seeing her she did copious blood tests, including vitamins and such, prescribed him (I believe vitamin D) supplements and he actually has noticed a difference how he feels, energy levels, etc. Of course, she is the one who prescribed his Metformin as well.
I think I'm going to see if she's taking new patients. My insurance is quite good as I work in state government. I can see pretty much any doctor in this town, though I do need referrals for specialists.
I'd rather be yelled at about my weight and blood sugar than have it ignored. Heck, I'd rather they burn incense and chant than do nothing at all.3 -
I know my PCM right now is enrolled in the whole body program - so they look at whole body health and not just symptoms of illness/injury, my insurance designates practioners who do that1
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I can't provide anything helpful regarding your doctor (who sounds like someone who's disinterested in her practice) because we have a different medical system. What I wish to do is give you a little bit of cautious hope. Many prediabetics and recently diagnosed fully diabetic people without a strong family history can go into remission and normalize their blood sugar with weight loss.
I was pre-diabetic. My morning readings were not as high as yours, but I constantly had them between 115 and 128. My doctor asked me if I wanted to attempt weight loss before prescribing medications to see if that improves my readings (he's quite reserved with medications for a doctor). I agreed to give it a try and at first it didn't look like it was working, but one day, when I crossed 50 something pounds lost, I woke up with lower than usual blood sugar almost overnight. It continued to go down gradually the more weight I lost until I was consistently registering a normal reading. I don't test as often now, but every month or two I pull out a strip just in case. My fasting blood sugar has been registering 75-85 consistently for the past year. As a bonus, my triglycerides are way down too, and my blood pressure has gone a bit down as well (I was pre-hypertensive).
Stick with it! Several of your conditions can see improvement with weight loss. You may not manage to completely leave the danger zone, but you will still be better off than where you started. I really wish you the best of luck and the resilience to stick with it.8 -
I can give you my story and you can glean whatever you can from it:
I was diagnosed T2Dm in January, 2014 with an A1C of 7.3. I was put on metformin but needed to switch to glipizide 3 weeks later because the metformin was compromising my kidneys.
My PCP is an APNP, not an MD (she is also a Certified Diabetic Educator). She told me to limit my total carbs to a maximum of 160 grams per day and spread them out over the day. I usually eat 5 meals so it was easy to do. This is considered moderate carb, not low carb. She also said I could spend my carb allowance however I choose since total carbs are the important number but I should make sure I get at least 25 grams of fiber in per day, also spread out. In other words, avoiding sugar isn't necessary but there has to be a balance to make sure the fiber is there.
5 months of losing 1 lb a week, eating moderate carb, and exercising, my A1C was down to 5.6. Three months later it was 5.3 and I was having low blood sugar moments so I was taken off the glipizide. I have managed my diabetes with moderate carbs and exercise ever since. my A1C has stayed between 5.0 and 5.2 for 2 years.
I did have a meeting with a Registered Dietician a few months after diagnosis. I was already logging on MFP so the appointment really turned out to be all about her confirming that I am doing the right things. She gave me some additional ideas for protein snacks because I was getting a bit bored with Greek yogurt and cheese but I really didn't need an overhaul of my diet.
I am a huge proponent of APNP's. Since they started as nurses, they have the interpersonal skills to see the patient as an entire person more than just another number. For basic wellness care, they are great and will do any referral necessary for specific issues.
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LadyLilion wrote: »It had been 126 or so the time before that! My husband (a1c of 7) was diagnosed as diabetic and given a meter, so I’ve used his a time or two and my fasting blood sugar is always over 130. For instance, this morning, about an hour after I got up, and with no food, it was 136.
The fasting blood sugar being so high has me quite concerned. Since I don’t have a meter or test strips of my own, I haven’t been taking it regularly so he doesn’t run out. He's only had his meter a couple weeks, so I've only tested a few times. But…he’s the one with diabetes, yet my sugar is always higher than his. Literally every time we’ve tested at the same time, I’m higher.
I want to address this separately. High fasting BG numbers in the morning can often be caused by something called "Dawn Syndrome". Basically, your body releases glucose into your system to prepare you to wake up and start your day. Not everyone has it, but is is very common. My morning numbers average around 120 but my pre-lunch numbers are closer to 100 and pre-dinner are around 95. This is why the A1C is the better number for seeing how well you are managing your BG.
Walmart has an inexpensive meter you can get with no prescription. Relion brand. The meter is $18 and you can get 100 test strips for $18. I use it for my additional readings and use my insurance-paid one for my morning fasting readings.
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If you don't have confidence in your doctor, you should definitely look into changing.
But wouldn't you rather not develop diabetes, than have a doctor who will prescribe something for prediabetes or diabetes? Losing weight and getting more exercise can normalize your blood glucose levels, and no doctor can make you do that. I realize you've already started on that, but I guess (just based on this one post, and I realize that's just a tiny snapshot into who you are) I feel like you're misplacing your mental and emotional energy on worrying about whether to change doctors (yeah, just do that) rather than on the things you can do yourself that could make a doctor's willingness to prescribe something or scold you irrelevant.0 -
Here's to put your mind a ease somewhat.
https://www.diabetesselfmanagement.com/blog/controlling-the-dawn-phenomenon/
I think the dawn phenomenon is giving you your high fasting numbers.
Keep working with your dietitian. Before I lost significant weight (over eighty pounds) I was on cholesterol, blood pressure, and diabetes (Metformin) medications. I'm not on any pills now. Losing the weight with the assistance of a dietitian can make a world of difference.
Squawk to whoever you need to for your own glucometer. Like you, I started taking control as soon as I got the prediabetes diagnosis. It pays to take this seriously, and you are taking all the right steps.2 -
LadyLilion wrote: »It had been 126 or so the time before that! My husband (a1c of 7) was diagnosed as diabetic and given a meter, so I’ve used his a time or two and my fasting blood sugar is always over 130. For instance, this morning, about an hour after I got up, and with no food, it was 136.
The fasting blood sugar being so high has me quite concerned. Since I don’t have a meter or test strips of my own, I haven’t been taking it regularly so he doesn’t run out. He's only had his meter a couple weeks, so I've only tested a few times. But…he’s the one with diabetes, yet my sugar is always higher than his. Literally every time we’ve tested at the same time, I’m higher.
I want to address this separately. High fasting BG numbers in the morning can often be caused by something called "Dawn Syndrome". Basically, your body releases glucose into your system to prepare you to wake up and start your day. Not everyone has it, but is is very common. My morning numbers average around 120 but my pre-lunch numbers are closer to 100 and pre-dinner are around 95. This is why the A1C is the better number for seeing how well you are managing your BG.
Walmart has an inexpensive meter you can get with no prescription. Relion brand. The meter is $18 and you can get 100 test strips for $18. I use it for my additional readings and use my insurance-paid one for my morning fasting readings.
Thank you, I'll consider that. I appreciate the information as well. I'll try getting a meter of my own and try at later times of the day. My readings are throwing off my husband's average anyway.lynn_glenmont wrote: »If you don't have confidence in your doctor, you should definitely look into changing.
But wouldn't you rather not develop diabetes, than have a doctor who will prescribe something for prediabetes or diabetes? Losing weight and getting more exercise can normalize your blood glucose levels, and no doctor can make you do that. I realize you've already started on that, but I guess (just based on this one post, and I realize that's just a tiny snapshot into who you are) I feel like you're misplacing your mental and emotional energy on worrying about whether to change doctors (yeah, just do that) rather than on the things you can do yourself that could make a doctor's willingness to prescribe something or scold you irrelevant.
Well if no one TELLS me what to do, I don't know...now do I? That's the issue. I already have a Rx and really, I'd rather NOT have someone just throw drugs at me. I don't want to be "scolded". I just want a doctor who will tell me what to do here. What I get is, "Oh your a1c is high. Have a pill and come back in 4 months." I have a concern and I can't even get in to see this woman for weeks generally. So yes, I'm definitely changing doctors.
I guess I was more wondering if this is just par for the course. I don't have any diabetic friends. My husband was literally diagnosed weeks ago, so he's new to this. If it's possible to actually reverse this and NOT become diabetic, that's the best possible outcome. But I don't get any feedback from my doctor. So I'm asking here.
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I want to address this separately. High fasting BG numbers in the morning can often be caused by something called "Dawn Syndrome". Basically, your body releases glucose into your system to prepare you to wake up and start your day. Not everyone has it, but is is very common. My morning numbers average around 120 but my pre-lunch numbers are closer to 100 and pre-dinner are around 95. This is why the A1C is the better number for seeing how well you are managing your BG.
I was recently diagnosed as diabetic, with a very high recent HbA1c number (10.4) and am now on Metformin, though at twice your dose. I had been noted in 2013 as pre-diabetic with an A1c number of 6, but was not prescribed anything other than a "lose some weight, tubby" - advice which I promptly ignored for years.
You should bring all your information forward to the appropriate health care provider, but for what it is worth, based on my panicked recent attempts at self-education and my doctor's advice as per Canadian protocols (not sure if those protocols may be different in the States), my understanding is the same as earlnabby's - the HbA1c results are the really important one for Type 2 diabetics (complete other situation for Type 1 diabetics).
In addition to the advice you mention, my understanding is that regular exercise (both cardio and resistance) are really important components of beneficial lifestyle changes in addition to weight loss for diabetics; regular exercise is important for reasons independent of whatever contribution it may make to weight loss.
Congratulations on the weight loss (awesome) and on getting your a1c number down to 6, which in Canada is considered to be managed for diabetics!
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5 months of losing 1 lb a week, eating moderate carb, and exercising, my A1C was down to 5.6. Three months later it was 5.3 and I was having low blood sugar moments so I was taken off the glipizide. I have managed my diabetes with moderate carbs and exercise ever since. my A1C has stayed between 5.0 and 5.2 for 2 years.
That is an awesome story to hear; thanks for sharing. I have announced all-out war against my recent diagnosis of Type 2 diabetes with the goal of reducing my a1c readings enough that I might over time wean off recently-prescribed Metformin (plus precautionary medication relating to cholesterol and blood pressure).
It is encouraging to read success stories such as yours.
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LadyLilion wrote: »
Words of wisdom? Suggestions? Information? I searched groups - but there doesn't seem to be one geared at diabetics...
Here's an active MFP group with good info: http://community.myfitnesspal.com/en/group/1772-type-2-diabetes-support-group
I use Bayer Contour Next Monitor and strips. You can find a meter for $5.00 on Amazon and 100 strips between $20.00- $25.00.
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sparky00721 wrote: »5 months of losing 1 lb a week, eating moderate carb, and exercising, my A1C was down to 5.6. Three months later it was 5.3 and I was having low blood sugar moments so I was taken off the glipizide. I have managed my diabetes with moderate carbs and exercise ever since. my A1C has stayed between 5.0 and 5.2 for 2 years.
That is an awesome story to hear; thanks for sharing. I have announced all-out war against my recent diagnosis of Type 2 diabetes with the goal of reducing my a1c readings enough that I might over time wean off recently-prescribed Metformin (plus precautionary medication relating to cholesterol and blood pressure).
It is encouraging to read success stories such as yours.
I agree. @earlnabby it's great to hear that. My husband's father was diagnosed 3 years ago and has managed with Metformin and diet just fine. Boy...to be able to get rid of the drugs would be great. Probably not likely that I'd lose all of mine, even at perfect weight, given my family cardio history...but even a couple pills would be awesome.
My job is so incredibly sedentary it's ridiculous. I have my Fitbit set at 7500 steps and find that hard to manage on busy days. I've had days I literally left my chair 3 x to pee and get something to eat and drink. Since March I've been trying to get a mile+ walk in at noon every day and I get up early and hit the elliptical more often than not. I know it's not enough, but it's more than I've done in years.1 -
Here's to put your mind a ease somewhat.
https://www.diabetesselfmanagement.com/blog/controlling-the-dawn-phenomenon/
I think the dawn phenomenon is giving you your high fasting numbers.
Keep working with your dietitian. Before I lost significant weight (over eighty pounds) I was on cholesterol, blood pressure, and diabetes (Metformin) medications. I'm not on any pills now. Losing the weight with the assistance of a dietitian can make a world of difference.
Squawk to whoever you need to for your own glucometer. Like you, I started taking control as soon as I got the prediabetes diagnosis. It pays to take this seriously, and you are taking all the right steps.
I agree with this, I have the same issue. My fastings are usually anywhere from 113-130, yet my last A1C in April was 5.8 - which is the high end of normal / low end of pre-diabetic. Either way, I need to fix it (hopefully by losing weight) but the fasting isn't always a good indicator of your overall blood sugar health. Also, if you don't feel comfortable with your doctor, switch! Trust your gut - I've done that twice now and finally found a great one. Good luck!
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A lower carb diet may help you with your numbers within days or weeks of starting. It may be something to consider. Dr Bernstein's Diabetes Solution is a fantastic book for any diabetic about reducing your insulin needs and reducing BG. Really good plan.
Dawn phenomenon can be a pain but metformin often helps with that. A change in diet (lowering carbs) can help many too, as can weight loss. Exercise too.
I went LCHF and now the only high numbers I get are fasting BG, but even those are not too high, just higher than what I want, like a 5.6. High BG can be reversible and controlled in many if not most diabetics.2 -
sparky00721 wrote: »5 months of losing 1 lb a week, eating moderate carb, and exercising, my A1C was down to 5.6. Three months later it was 5.3 and I was having low blood sugar moments so I was taken off the glipizide. I have managed my diabetes with moderate carbs and exercise ever since. my A1C has stayed between 5.0 and 5.2 for 2 years.
That is an awesome story to hear; thanks for sharing. I have announced all-out war against my recent diagnosis of Type 2 diabetes with the goal of reducing my a1c readings enough that I might over time wean off recently-prescribed Metformin (plus precautionary medication relating to cholesterol and blood pressure).
It is encouraging to read success stories such as yours.
That is exactly what I did. All out war with the goal of getting off the meds ASAP.0 -
I have a young primary care doctor that graduated just over a year ago. He recommended the ADAPT program which is a pre-diabetes lifestyle (diet) education program for a year. I have already lost 10 lbs....and down now to 269. My doc recommended sleep apnea test.....which came back positive; I ended up 11 seconds without breathing and oxygen level as low as 81 which should be 95. I will be fitted for cpap by the end of the month. Now is time for YOU to SHOP around for another doctor; check with friends or med clinic staff for a better doctor. YOU need to ADVOCATE for your healthcare....and don't accept 2nd class doc....you deserve better!2
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Word of wisdom: My father-in-law had a hemorrhagic stroke yesterday. The neurologist speculated that it was due to a spike in his already high blood pressure. His kidney function is poor, which is an eventuality of his diabetes. I've known this man more than 37 years and I know he has never cared to do or learn anything about his health. Stay fat. Stay sick. And be on track to die after a long and wretched decline.
My point is, you and I have the power to avoid that. Lose weight eating as a person who is slim and healthy. Lose the weight and exit the pre-diabetic state. Lose the weight and get your blood pressure down. Lose the weight and extend the years of your healthy life.3 -
Sorry to hear about your Father in law.0
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LadyLilion wrote: »LadyLilion wrote: »It had been 126 or so the time before that! My husband (a1c of 7) was diagnosed as diabetic and given a meter, so I’ve used his a time or two and my fasting blood sugar is always over 130. For instance, this morning, about an hour after I got up, and with no food, it was 136.
The fasting blood sugar being so high has me quite concerned. Since I don’t have a meter or test strips of my own, I haven’t been taking it regularly so he doesn’t run out. He's only had his meter a couple weeks, so I've only tested a few times. But…he’s the one with diabetes, yet my sugar is always higher than his. Literally every time we’ve tested at the same time, I’m higher.
I want to address this separately. High fasting BG numbers in the morning can often be caused by something called "Dawn Syndrome". Basically, your body releases glucose into your system to prepare you to wake up and start your day. Not everyone has it, but is is very common. My morning numbers average around 120 but my pre-lunch numbers are closer to 100 and pre-dinner are around 95. This is why the A1C is the better number for seeing how well you are managing your BG.
Walmart has an inexpensive meter you can get with no prescription. Relion brand. The meter is $18 and you can get 100 test strips for $18. I use it for my additional readings and use my insurance-paid one for my morning fasting readings.
Thank you, I'll consider that. I appreciate the information as well. I'll try getting a meter of my own and try at later times of the day. My readings are throwing off my husband's average anyway.lynn_glenmont wrote: »If you don't have confidence in your doctor, you should definitely look into changing.
But wouldn't you rather not develop diabetes, than have a doctor who will prescribe something for prediabetes or diabetes? Losing weight and getting more exercise can normalize your blood glucose levels, and no doctor can make you do that. I realize you've already started on that, but I guess (just based on this one post, and I realize that's just a tiny snapshot into who you are) I feel like you're misplacing your mental and emotional energy on worrying about whether to change doctors (yeah, just do that) rather than on the things you can do yourself that could make a doctor's willingness to prescribe something or scold you irrelevant.
Well if no one TELLS me what to do, I don't know...now do I? That's the issue. I already have a Rx and really, I'd rather NOT have someone just throw drugs at me. I don't want to be "scolded". I just want a doctor who will tell me what to do here. What I get is, "Oh your a1c is high. Have a pill and come back in 4 months." I have a concern and I can't even get in to see this woman for weeks generally. So yes, I'm definitely changing doctors.
I guess I was more wondering if this is just par for the course. I don't have any diabetic friends. My husband was literally diagnosed weeks ago, so he's new to this. If it's possible to actually reverse this and NOT become diabetic, that's the best possible outcome. But I don't get any feedback from my doctor. So I'm asking here.
(Please try reading this in the gentlest voice you can imagine. Kermit the Frog? B/c your response to my first post seemed like you were having an intense emotional reaction to it.)
So, I did offer advice, which was that the best thing you could do to try to turn your pre-diabetes around (and you can do this without a doctor, old or new) is to exercise and lose weight. (It's in the part of my post that you didn't bold and didn't respond to, so I'm not sure if you read past it.) @amusedmonkey also suggested weight loss as a powerful tool in addressing a number of your conditions, but I didn't see if you responded to her.
I started on MFP because I was scared by a blood glucose reading at the high end of the pre-diabetic range. I tracked my calories, lost 15% of my body weight, started walking more (and eventually added other exercise, but initially it was just increasing my walking), and at my next doctor's appointment my A1C was completely normal. My cholesterol numbers and blood pressure also improved.
If you want to do more than that, you can try managing your carb intake as though you were diabetic. I didn't find that necessary, but that's not to say it might not help you. I've also seen study reports that suggest increasing your omega-3 intake can help (common sources: fatty fish, flaxseed and flax oil, canola oil, grass-fed beef, eggs from truly free-range chickens, or from chickens whose feed is supplemented with flax and other high omega-3 foods).
I agree with @earlnabby that the A1C reading is more important than momentary glucose readings, and it's great that you've got yours headed back down.
I'm looking back at your OP, and you were concerned your doctor didn't give you "diet suggestions" -- do you mean like certain foods you should eat more of or avoid, or do you mean like an overall plan to lose weight, like keto or LCHF or paleo or IF? Because you don't need to follow some specific plan. Whatever you're doing is working fine. Eighteen pounds in three months is great progress.
I realize your doctor is not responsive, but until you make the jump to a new doctor, you might want to double-check on how you're taking the metformin. Your post indicates that you believe the instruction to take with meals is just to avoid stomach upset, but **one way** it works by decreasing insulin resistance, so the glucose gets out of blood and into your cells. I have no training in pharmacology, so I don't know whether it matters or not, but it certainly seems possible that it's meant to be taken with meals so you have the metformin at the same time that the glucose is hitting your bloodstream. I could be wrong -- it could build up in your system over time, and taking it once a day could be perfectly effective, but if it were me, I would want to know for sure.
ETA **one way**4 -
I'm trained and worked as a dietitian for a few years (full disclosure, I'm no longer licensed since I went back to school for something else). I'm not terribly comfortable posting on here since I don't want to be mobbed with questions but diabetes was one of my biggest interests as a dietitian, so I had to weigh in.
I'm sorry to hear that your Dr. is cold and not taking your concerns seriously. I absolutely suggest trying to find a new Doctor. I would also suggest asking that doctor if you should be seeing an endochronologist, but with pre-diabetes it might not be necessary at this time.
When it comes to fasting glucose vs A1c vs post meal sugars it can get a little complicated but the simplest way I can explain it is that your sugar normally goes up and down with, and between, meals. This is normal since the food we eat is broken down into glucose (so it goes up after eating) and is used for energy and slowly depleted in the blood (will go down a few hours after a meal, assuming you haven't eaten anything else).
A1c is an amazing indicator of your AVERAGE blood sugar over the past 3 months. So it can be great, or it is sometimes misleading. The dawn phenomenon is definitely something that sounds like what You've been experiencing but to know for sure I'd suggest testing your sugars at other "fasting" times during the day (over 2 hours after a meal, or right before the next meal). But the fact that your A1c is within "normal" and that you've lost 18 lbs (good for you!!!) I would say you're definitely heading in the right direction.
I would also always suggest taking your meds as prescribed, but in response to the previous post, metformin is one that doesn't HAVE to be taken with a meal since it won't induce low blood sugar episodes.
So to answer you original question; this is mostly normal and doesn't mean you necessarily have type 2 diabetes. The guidelines are just that, they're not set in stone and should be use patient to patient. You are doing everything you should be doing by eating healthy, educating yourself, and (hopefully) finding a better doctor.
Hope this helps you!9 -
you should be able to get your husband and your self in to see dietician and diabetic nurse. groups courses and all the fun stuff. you need a doctor who cares that's important. you both can fight it. with clean eating switching food groups up. witch is where a dietician can help. the nurse she can help with meds and exercise. you want to get it nipped in the butt before either of you get put on insulin because poking your self daily sucks1
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