Pre-diabetic, questions and concerns. Can anyone help?
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In addition to the helpful advice others have already given, I'd recommend seeing whether your/your husband's medical group or your local hospital has diabetes education classes or groups. Many hospitals and medical groups have 6-12 week diabetes education programs that focus on a lot of the things that it sounds like you're looking for: how to meal plan, how to fit more activity into your day, etc.0
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Wow, I've gotten many, many more replies than I expected. I'll do my best to respond to them, but if I miss you, please don't think that I didn't read and appreciate your response. I truly do appreciate the input.
@lynn_glenmont I'm sorry if I came across upset. Type has a way to just not grasp the inflection you intend. I suppose I haven't responded to all the "lose weight - be active" replies because it should be obvious I'm already working on that. I said in my first post, "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." Completely true. I'm not even sure what I'm asking. I posted that just kind of freaked out after doing a quick google search that told me 136 was WAY too high. I didn't even know what a "normal" fasting number was since my doctor just never talked to me about any of this. She never suggested monitoring. She just, literally, told me to take pills and come back in 4 months.
I really didn't talk about any of this to the dietician, because I really was just seeing her for weight loss. Kind of stupid in retrospect.
On the issue of how to take the Metformin...this is the first time anyone's told me that with food was the way to take it for a reason other than stomach upset. Even my husband's doctor told him to take it with food but stressed it was because he has IBSD and gets digestive issues regularly. My dietician - who is a certified diabetes educator - mentioned she takes hers with food - but given how young and slim she is I suspect she doesn't have a dozen pills to keep track of and she mentioned stomach upset...so I just figured that was why she took it that way. I'll certainly look into whether I'm taking it too late at night or if it is necessary to take it with meals, for me and my husband, who has started taking his like I do. It's just so much easier to remember at bedtime.
@biancabantoto - thank you. Your reply calmed me down a bit. I think I've been stressing about that morning number so much that, combined with not really trusting my doctor, I've had myself worked up more than necessary.
Thank EVERYONE who mentioned the dawn phenomenon - I looked it up. Gives me some peace of mind to know that this could just be "me".
@150poundsofme - My dietician can likely give me a meter - she gave my husband his but didn't offer me one. Probably because he's "diabetic" and I'm not. (After we began our diet and I was on Metformin my number went from 6.5 to 6. His, with the same diet, much more activity normally than I get, and no Metformin, went from 6.5 to 7.) I know she can't give strips, but they aren't terribly expensive without a prescription and with a prescription are free. When I change doctors, I'll ask the new one.
@JeromeBarry1 - Yes, I read the second paragraph. Thank you for the encouragement.
@Azdak - Our dietician is a certified diabetes educator, and diabetic herself. I suspect based on her age and how very fit she is she's a type 1 diabetic...but I don't actually know. I've actually been seeing her for over a year - the first year not terribly regularly, we get six free visits per year with a dietician through our insurance and I was referred by the nurse practitioner that staffs a clinic connected to our wellness program. Anyway, I paid attention and did okay for a while the first year, then for lots of reasons that aren't important to anyone but me - family issues - I kind of stopped paying attention and actually gained weight. Now that life has resolved (or at least I've become resolved to it) and our lives are back on track, we are seeing her monthly together. Seemed to make no sense to have my husband one month and me the next when we eat the same food after all. She seems to think we're doing fine, really. She offered the classes to us...but has said she thinks we're going about things the right way - now. When I see her in a couple weeks, I'll talk to her more about the testing.
@masaku_88 - thanks for your suggestion.
@phoenixmed - I suppose I should talk to her...but I really don't know how to say what I need to. Truthfully, I just don't like the very large medical group format she's a part of. My last doctor was in the same group, but had a separate, smaller clinic and it was just...better. I felt like when you called, the people remembered your name. Maybe I'm just old and small-town, but the feeling of being "faceless" just really bothers me and I think she's so rushed, the response would be, "I have 500 patients. Who are you?"
Yeah...I need a different doctor.
@earlnabby - good suggestions. Thank you.
@RoteBook - I may see if I can fit a class or two in and see what they're like. The dietician didn't push them. She thinks we're doing okay...I'm the one who's not so sure.
Again, @RodaRose , @katieiwoosley @donnalhoff @BlueSkyShoal @YvetteK2015 @amusedmonkey @jgnatca @Daddy78230 @eissacf25 @nvmomketo @eskimodeb2 @michael1976_ca - Thanks to all of you. I do appreciate all your responses.
As I said, I think I was just momentarily freaked out when I realized what a "normal" fasting glucose should be and how abnormal my readings were! Combined with my general unhappiness with my doctor, I overreacted. I do that. My plan at the moment is 1- keep up with the weight loss and exercise (of course), 2 - find a new doctor, 3 - Make a list of things to discuss with the dietician when I see her next, including those classes. 4 - look into the "when to take Metformin" issue.
Thanks again.3 -
Be careful of carbs they they are pretty much the same as sugar for a diabetic. Both will raise blood sugar. Talk to a dietitian, a diabetic diet can be complicated.0
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I just want to point out that some people will develop diabetes regardless of their weight. Weight is a risk factor, but not the only factor. I may have to go back on Metformin one day.
More about how Metformin works. It builds up in the system gradually so there's no magic as to when to take it. It can induce nausea, especially at the beginning. Which is why it is suggested to take it with food. Because also of the potential for nausea, dosage is usually increased slowly.3 -
eileenmccaskey wrote: »Be careful of carbs they they are pretty much the same as sugar for a diabetic. Both will raise blood sugar. Talk to a dietitian, a diabetic diet can be complicated.
See...this is why I get so concerned about what I'm doing. I have people saying, "Carbs are terrible. Diabetic's diets are complicated. Don't do this, don't do that."
I have people saying, "Oh my wonderful keto diet with 20 grams of carbs a day! I've lost 20 lbs in the time you've lost 5! I'm never hungry and I feel awesome!"
I have a dietician who is a CDE who says, "If you want a potato, eat a potato. You're doing great." and who is absolutely, 100% vehemently opposed to the keto-type diets...I asked her last visit about that. Thinks they are terrible for you and impossible to maintain long-term. (And I think for me that second part is definitely correct. Could I go a month without a carb? Yes. Could I go the rest of my life without bread? Not unless it was definitely going to kill me.)
I have a doctor saying...nothing.I just want to point out that some people will develop diabetes regardless of their weight. Weight is a risk factor, but not the only factor. I may have to go back on Metformin one day.
More about how Metformin works. It builds up in the system gradually so there's no magic as to when to take it. It can induce nausea, especially at the beginning. Which is why it is suggested to take it with food. Because also of the potential for nausea, dosage is usually increased slowly.
My doctor warned me about nausea...and told me I'd likely lose weight. The first few months I took it, I gained.
lol I've had ZERO side effects.
You know, diabetes was simply not anything I ever anticipated. Stupid of me. I mean, the human body simply isn't designed to be healthy at 300+ lbs. But my family has zero diabetic history. Heart disease and hypertension out the wazoo...but no diabetes. I worried about eating saturated fats, not sugar. My husband's family has a history...so his was always a concern. But I guess that means I simply ate my way here, which makes it somehow worse.0 -
@LadyLilion - in regards to carbs, they are not bad - it's all how much you have, how much sugar make up those carbs and pairing it with protein. Everyone reacts to food differently, and at different times of day. What raises my blood sugar in the morning, doesn't raise it as high in the afternoon. Getting a meter and checking your blood for a couple weeks after meals will help you see how your body reacts to the food you're eating. I aim for 7 g of protein for every 15g of carbs and found that ratio works well for my numbers.1
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LadyLilion wrote: »eileenmccaskey wrote: »Be careful of carbs they they are pretty much the same as sugar for a diabetic. Both will raise blood sugar. Talk to a dietitian, a diabetic diet can be complicated.
See...this is why I get so concerned about what I'm doing. I have people saying, "Carbs are terrible. Diabetic's diets are complicated. Don't do this, don't do that."
I have people saying, "Oh my wonderful keto diet with 20 grams of carbs a day! I've lost 20 lbs in the time you've lost 5! I'm never hungry and I feel awesome!"
I have a dietician who is a CDE who says, "If you want a potato, eat a potato. You're doing great." and who is absolutely, 100% vehemently opposed to the keto-type diets...I asked her last visit about that. Thinks they are terrible for you and impossible to maintain long-term. (And I think for me that second part is definitely correct. Could I go a month without a carb? Yes. Could I go the rest of my life without bread? Not unless it was definitely going to kill me.)
I have a doctor saying...nothing.I just want to point out that some people will develop diabetes regardless of their weight. Weight is a risk factor, but not the only factor. I may have to go back on Metformin one day.
More about how Metformin works. It builds up in the system gradually so there's no magic as to when to take it. It can induce nausea, especially at the beginning. Which is why it is suggested to take it with food. Because also of the potential for nausea, dosage is usually increased slowly.
My doctor warned me about nausea...and told me I'd likely lose weight. The first few months I took it, I gained. lol I've had ZERO side effects.
You know, diabetes was simply not anything I ever anticipated. Stupid of me. I mean, the human body simply isn't designed to be healthy at 300+ lbs. But my family has zero diabetic history. Heart disease and hypertension out the wazoo...but no diabetes. I worried about eating saturated fats, not sugar. My husband's family has a history...so his was always a concern. But I guess that means I simply ate my way here, which makes it somehow worse.
Think of the carbs thing as a sliding scale rather than an "all-or-nothing" thing. I have been managing my diabetes just fine on moderate carbs (160 g per day) and I get to spend them however I want, just spread out over the day rather than in one meal. These are the instructions give to me by my CDE and they work for me.
Others need to eat fewer carbs and some can eat more than I do. It really depends on how advanced the diabetes is. Since you are pre-diabetic, chances are really good that you can eat on the higher end of the scale like I do. Don't be afraid of carbs, just make sure that whatever you are doing is working for you. Yes, if you want a potato, eat a potato.
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I know you would rather not be tossed Metformin without any guidance but if you tolerated well, you could probably double the dose (with your new doctor's OK).
I didn't lose any weight on Metformin either. I lost when I tracked and ate at a deficit.0 -
Oh yeah, I started to feel a whole lot better after I lost my first twenty pounds. Any control you get back is going to help you feel a whole lot better.
About being sedentary. I was where you are. Don't worry about hitting a minimum or an ideal. The trick with exercise is to start where you are and gradually increase. (Add 10% at a time). This gives your body time to adapt to new demands. And it does. I find exercise to be more rewarding than the scale as I start to feel the difference right away.0 -
I know you would rather not be tossed Metformin without any guidance but if you tolerated well, you could probably double the dose (with your new doctor's OK).
I will say this for my doctor. The one thing she's done that pleased me was ASK me if I wanted to up to dosage of Metformin and when I said I'd rather wait and see what happens as I lose weight, her response was, "Okay, we'll leave it where it is for now." So while she was quick to prescribe...she didn't push when I balked at more.About being sedentary. I was where you are. Don't worry about hitting a minimum or an ideal. The trick with exercise is to start where you are and gradually increase. (Add 10% at a time). This gives your body time to adapt to new demands. And it does. I find exercise to be more rewarding than the scale as I start to feel the difference right away.
I was horrified when I got my Fitbit and realized I get like 2000 steps a day unless I actually work at it. I have my goal set at 7500 and I can usually get that...but not always. It constantly surprises me how few steps it takes to actually do something. It just seems like a mile should take more than about 2000 steps. I skipped my morning elliptical this morning and took a 1.6 mile walk at lunch. I'm barely over 5,000 now.
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LadyLilion wrote: »I know you would rather not be tossed Metformin without any guidance but if you tolerated well, you could probably double the dose (with your new doctor's OK).
I will say this for my doctor. The one thing she's done that pleased me was ASK me if I wanted to up to dosage of Metformin and when I said I'd rather wait and see what happens as I lose weight, her response was, "Okay, we'll leave it where it is for now." So while she was quick to prescribe...she didn't push when I balked at more.About being sedentary. I was where you are. Don't worry about hitting a minimum or an ideal. The trick with exercise is to start where you are and gradually increase. (Add 10% at a time). This gives your body time to adapt to new demands. And it does. I find exercise to be more rewarding than the scale as I start to feel the difference right away.
I was horrified when I got my Fitbit and realized I get like 2000 steps a day unless I actually work at it. I have my goal set at 7500 and I can usually get that...but not always. It constantly surprises me how few steps it takes to actually do something. It just seems like a mile should take more than about 2000 steps. I skipped my morning elliptical this morning and took a 1.6 mile walk at lunch. I'm barely over 5,000 now.
That is the biggest eye opener when you get a tracker. I had no idea I got so few steps in a day. Over time, you will find ways to fit more activity in.2 -
Your fasting blood glucose is not high enougjt to mandate an increasing of dose. It is truly the a1c that is important.
Metformin is a stable weight hypoglycemiants ( wich means it is not supposed to make your lose or gain weight.
Keto diets and such is a great way to regain all your wight when you give up and are no good for long term. I perfectly agree with your dietetician. Eat a potatoe if you want. Just not 3 in the same meal2 -
phoenixmed wrote: »Your fasting blood glucose is not high enougjt to mandate an increasing of dose. It is truly the a1c that is important.
Metformin is a stable weight hypoglycemiants ( wich means it is not supposed to make your lose or gain weight.
Keto diets and such is a great way to regain all your wight when you give up and are no good for long term. I perfectly agree with your dietetician. Eat a potatoe if you want. Just not 3 in the same meal
Thanks.
I would never usually ask a doctor a question outside of the office - I'm a lawyer, hate it when people do that to me...BUT, since you offered:
You previously said, "I as a doctor seriously think that a doctor who prescribes a lot of blood work (somebody mentionned vitamines and such) is at risk of overdiagnosis. Iatrogenic harm and definitely disagree with the choosing wisely approach to modern medecine."
I don't think I understand you. Why would you disagree with choosing wisely? Can you explain what you meant?
The metformin...with dinner, or just before bed, given that I only take it once a day?0 -
LadyLilion wrote: »phoenixmed wrote: »Your fasting blood glucose is not high enougjt to mandate an increasing of dose. It is truly the a1c that is important.
Metformin is a stable weight hypoglycemiants ( wich means it is not supposed to make your lose or gain weight.
Keto diets and such is a great way to regain all your wight when you give up and are no good for long term. I perfectly agree with your dietetician. Eat a potatoe if you want. Just not 3 in the same meal
Thanks.
I would never usually ask a doctor a question outside of the office - I'm a lawyer, hate it when people do that to me...BUT, since you offered:
You previously said, "I as a doctor seriously think that a doctor who prescribes a lot of blood work (somebody mentionned vitamines and such) is at risk of overdiagnosis. Iatrogenic harm and definitely disagree with the choosing wisely approach to modern medicine."
I don't think I understand you. Why would you disagree with choosing wisely? Can you explain what you meant?
The metformin...with dinner, or just before bed, given that I only take it once a day?
Pharmacists can be partners and resources for you in getting healthy. Call the pharmacy where you get your metformin to ask when is the best time to take your medication.
In a way, your doctor did the right thing by handing you a prescription for a pill and telling you to return at a certain scheduled time. Sometimes that system works well. If you want more than that, get another doctor.
If you want, ask the doctor's office for the blood testing monitor. They get them free from the companies. What costs your insurance company are the strips.
At one point in my life many years ago, I was married to a type 1 diabetic. Later I had a close friend with diabetes 2 who struggled with managing her diabetes. Both had very serious consequences from diabetes. I say this to show that I have an understanding of diabetes from the perspective of a loved one.
I have a brother-law who is managing his diabetes well. He lost weight and makes good food choices now. His test results are good. He is still on a small dose of medicine.
The blood glucose monitors sometimes are not extremely accurate even when the monitor is calibrated. https://diatribe.org/fda-publishes-final-recommendations-blood-glucose-meter-accuracy
The A1c counts the most.
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There are several schools of thought on what to eat. Things can be confusing because some schools even contradict each other. There is lots of information available if you want it. YouTube has some good videos explaining the role of the liver and glucose for example. Find a book or two by a reputable respected writer. Otherwise, find a doctor you can trust and who pays attention to your questions and concerns. Pay attention to your body. Good luck to you and your husband.
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