Prediabetes?
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| Sat, 09-01-2007 - 12:32pm |
Hi Everyone,
I am new to this board but have been a member of iVillage for a little while. About 5 years ago, I weighed about 230 pounds and had a miscarriage at 11 weeks, and at that time, they did a gestational diabetes test to see if that might have contributed to the cause of the miscarriage. They diagnosed me as "borderline prediabetic". Over the next 4 years, I'd gained another 30 pounds and had another blood sugar test during my regular physical. There was a miscommunication in that the dr. thought I'd been fasting, but I hadn't been as I didn't realize I needed to. Anyway, that test came back at 106, which the dr. told me was concerning, so I needed to lose weight and exercise.
I have been working hard on that for the past 6 months, have lost almost 50 pounds, and am eating very healthy. I was excited for my physical to see how my blood sugar would improve, especially since I wasn't really fasting when it was 106, so I was expecting it to be totally and completely under control now, like a result of between 80-90 or something. But, it wasn't. It was 101.
My cholesterol numbers are all excellent - much better than before and all completely normal. So, I know my exercise and healthy eating habits are doing something, but I just really wanted to get out of that "prediabetes" range. This is especially important as my husband and I want to try again to get pregnant, and I am worried what effect my blood sugar level might have.
So, my questions for you all are:
1) How could I still be 101 now - fasting, eating healthy and exercising regularly, when I was 106 last year - almost 50 pounds heavier, eating like crap, and not even fasting for the test? How is that even possible?
2) Does exercise interfere with fasting blood sugar levels? I did my normal morning exercise of walking briskly for an hour, just about an hour before this fasting blood test was taken. Could that have had an effect on the test?
3) Once you get up into the prediabetic and diabetic blood sugar ranges, is it very difficult to get back out? Might that be why I only dropped 5 points after 6 months of lifestyle change?
4) Are there any precautions I should take with regarding to getting (and staying) pregnant with regards to still being in this "prediabetic" range?
5) Or, alternatively, is 101 so close to the normal range that it really isn't anything to be concerned about?
Thank you for any information you can provide. I will of course discuss more with my dr., but I just wanted to get some information from all of you to see what your personal experiences are.
Thanks!

Hi and welcome to the board. I am going to try and answer your questions one at a time.
So, my questions for you all are:
1) How could I still be 101 now - fasting, eating healthy and exercising regularly, when I was 106 last year - almost 50 pounds heavier, eating like crap, and not even fasting for the test? How is that even possible?Diabetes is a progressive disease which gets worse over time, especially without treatment. I am frankly surprised that they were concerned when your test showed 106 without you fasting.
2) Does exercise interfere with fasting blood sugar levels? I did my normal morning exercise of walking briskly for an hour, just about an hour before this fasting blood test was taken. Could that have had an effect on the test? Exercise can and usually does drop your blood sugar levels and so your blood sugar may have been even higher before you exercised. If you have the capacity try testing your blood sugar before you exercise and then afterwards. Sometimes I can drop my blood sugar 30 points with exercising. Because it was early in the morning it is possible that you were showing insulin resistance. This is seen where your early morning blood sugar is higher than your blood sugar at bedtime.
3) Once you get up into the prediabetic and diabetic blood sugar ranges, is it very difficult to get back out? Might that be why I only dropped 5 points after 6 months of lifestyle change? It is hoped with the prediabetes diagnosis that if the person makes the necessary life style changes that they can prevent or at least delay the diagnosis of diabetes. Type 2 diabetes developes over a 12-20 year period and who knows where you are on that journey. But it is absolutely wonderful that you lost this much weight and that your cholesterol is good. It really means that the life style changes taht you ahve made are working for you. You are to be congratulated.
4) Are there any precautions I should take with regarding to getting (and staying) pregnant with regards to still being in this "prediabetic" range? When you become pregnant you need to be cared for by a high risk pregnancy practice. You also need to be seen by a dietitian for meal planning help. When pregnant doctors are much stricter with the blood sugar reading especially early in the pregnancy and also they are stricter with the amount of weight that is gained. There is much discussion lately about the amount of weight women are gaining in pregrancy and whether it is causing more diabetes diagnosises and more c-sections. When I was in nursing school we were told that women should only gain 20-30 pounds and then the guidelines were loosened. It looks like it is going back to what I was taught.
At this point I would just suggest that you continue to exercise, eat right and try and get your weight as close to normal as possible.
5) Or, alternatively, is 101 so close to the normal range that it really isn't anything to be concerned about?
It is really close. Did you by any chance have an A1C test done? That would tell us what your average blood sugar has been over the previous 2-3 months and that would be an indicator if this test result was valid.
I hope I have given you some thought to discuss with your physician. Please let us know what their recommendation is for you. And good luck with your potential pregnancy. We love being cyber aunties!
I, too, am surprised that the doctor was so concerned about your 106 reading, but it really is better to be on top of things than to wait until everything is out of hand.
I really wanted to respond to your question about exercise.
Thanks for all of the information!
I just want to clarify one thing: The dr. didn't realize that I wasn't fasting when I got the 106 result. So, he wasn't concerned with a 106 "non-fasting" result, but rather what he thought was a 106 fasting result. And, he wasn't overly concerned, he just told me that I should get my weight in check and exercise to get it under control.
He hasn't said anything about my 101 result specifically, other than that my labs were all within normal or "acceptable" levels. So, I don't think he is concerned anymore, but we have not spoken specifically about that result yet.
I was just disappointed, since I was hoping to have more than a 5 point drop in the number, especially since I wasn't fasting before and my lifestyle has improved so drastically.
I have not had an A1C test done. However, I do have a blood sugar monitor. When I was originally diagnosed with the "borderline prediabetic" gestational diabetes test, I saw a nutritionist and was put on a restricted diet. This diet made me feel very weak, though, to the point of feeling like I was going to pass out. So, that is when I got the blood sugar monitor to make sure the levels weren't getting too low or anything like that.
All of my strips have expired, but I tried to take my own blood sugar today just out of curiosity. I took two tests in a row, and they differed by 20 points, so I am assuming that is because the strips are expired.
But, if I get some new strips, do you happen to know if the testing I do on the monitor is the same as what they do with bloodwork at the dr.'s? (The test was descibed as GLUCOSE, FASTING - 101 mg/dL)
Also, another question I thought of: My physical was on a Monday after a big county fair in our area, where I ate more sweets and junk than I normally eat. Could the "worse than usual" weekend eating have affected my levels on Monday morning, even after fasting for over 12 hours?
In any case, thanks for the info, and I will definitely keep you updated...
The meter test is different than the one the blood test would do.
Thanks everyone for the responses again!
It is good to know that my meter is not as accurate as the dr.'s blood test, and also that the exercise may have caused my BG to either increase or decrease. If it caused it to increase, that would mean that my true waking BG would have been well within the normal range, and that it was simply elevated due to my body needing it for the exercise. If it cased it to decrease, then that is more concerning, as my waking BG would have been higher then.
So, I think I will get some new strips and just do a little testing of my own by checking my BG before and after exercise. I will also check my early morning versus before bedtime levels to make sure I am not showing insulin resistance (I assume that is a bad thing.).
I am assuming that while the test strips are not as accurate as the true blood test, I would still be able to determine trends accurately (whether morning is higher or lower than evening, whether exercise increases or descreases my BG, etc.).
If, by doing this, I find something more concerning, I will make an appointment with my dr. to discuss. If not, I will just not worry about it. I am doing what I'm supposed to be doing anyway, even if I do have prediabetes, since I am eating right, continuing to lose about a pound a week, and am exercising daily.
I wouldn't be worried at all regardless if it weren't for the fact that my husband and I really want children, and we've had trouble in that department in the past, possibly related to elevated BG levels (of course, I was heavier then, but still). So, I just want to do everything in my power to make sure there isn't any more I should be doing.
Yes, as long as you test from the same 'location' it will be fairly accurate as to any trends.
You didn't ask me to reply but I can't resist!
But, if I get some new strips, do you happen to know if the testing I do on the monitor is the same as what they do with bloodwork at the dr.'s? (The test was descibed as GLUCOSE, FASTING - 101 mg/dL)
No the tests are different. Here is why. The most accurate results are the ones performed by the laboratory. The results that you see with your meter may vary as much a s 15-20 percent but they are the most accurate that we can get using finger sticks. The only way to check your meter is to run the lab test and a blood sugar test at exactly the same time using the same blood. Because of circulation time if a blood sugar reading using a finger stick is critical, it must be done on the fingers and not using alternative sites. For your information the blood that the lab uses is venous blood and the blood that you and I use is peripheral blood and the results will be different.
Also, another question I thought of: My physical was on a Monday after a big county fair in our area, where I ate more sweets and junk than I normally eat. Could the "worse than usual" weekend eating have affected my levels on Monday morning, even after fasting for over 12 hours?
Probably not because you had a 12 hour fast. It would have most affected your A1C, which you didn't have done, and your cholesterol which was reported as within normal limits.
Hi,
This is what happens when you don't read the whole thread before responding!
You can also do a modified glucose tolerance test on yourself. Measure your fasting blood sugar and then measure it again two hours after you eat. Your blood sugar should not be more than 40 points higher than your fasting blood sugar and hopefully under 140. You don't need to do this everyday, just once in a while to see how you are doing. If you consistently don't meet these goals contact your physician and show him or her your blood sugar log. They can take from there.