I think I'm pre-diabetic but my Doc didn't bring it to my attention. WWYD?

Two Peas is Closing
Click here to visit our final product sale. Click here to visit our FAQ page regarding the closing of Two Peas.

Posted 3/3/2013 by TREZmom in NSBR Board
 

TREZmom
Lost and Found in Pea-land

PeaNut 138,098
March 2004
Posts: 6,558
Layouts: 2
Loc: NC but wishing I was somewhere else

Posted: 3/3/2013 11:56:35 AM
I have a strong family history of diabetes (grandmother had it, dad has it, uncles and aunts have it), so I'm hyper-vigilant about it. Looking at some blood tests from August 2011, I noticed some weird things (abnormal anion gap and carbon dioxide levels), so I asked my Primary Care Manager (PCM), who is actually a Nurse Practitioner to investigate this further. She ordered some more blood tests and found out my A1C level was 5.6 (which is considered normal), but my Glucose was 114. This clearly makes me pre-diabetic doesn't it? I read online that a reading between 100-125 is pre-diabetes. The PCM, basically said, I was fine and failed to give me any nutrition counseling, weight management help, etc.

I'm currently trying to lose weight, although I'm considered a healthy weight. This was a major wakeup call for me though. From what I was reading, I could develop Type II diabetes in the next decade. I also have slightly elevated cholesterol and could be a higher risk for developing heart disease. I'm 44 years old and that information really scares me.

That being said, do you think I should make an issue of it with my PCM? Maybe get a second opinion? Do you think the Nurse Practitioner is negligent, by not informing me of the pre-diabetes? We're military, so I'm not sure of the process of changing providers or if I should. I actually like my PCM, other than the fact that she seems super busy lately.

I'm just curious, what would you do? TIA.

voltagain
OklaPhoma

PeaNut 18,334
July 2001
Posts: 38,143
Layouts: 15
Loc: State of cultural confusion. Yeehaw and Aloha have collided!

Posted: 3/3/2013 11:59:22 AM
but my Glucose was 114. This clearly makes me pre-diabetic doesn't it? I read online that a reading between 100-125 is pre-diabetes.
>>>>>>>>>>>>>>>>>>>

No, a reading of 114 does not automatically make you prediabetic. It depends on how long ago you had eaten. Most docs, especially in the military, use over 125 with an eight hour fast as the standard for pre-diabetes. But the biggest sign is your a1c which is not in a diabetes range at all.


What Your Kit Lens Can Do For You

Canon 60d, Canon 24-70mm 2.8L, Canon 70-200mm 2.8L, 50mm 1.8, 28-80, 75-300mm and Tamron 90mm 2.8 macro

TREZmom
Lost and Found in Pea-land

PeaNut 138,098
March 2004
Posts: 6,558
Layouts: 2
Loc: NC but wishing I was somewhere else

Posted: 3/3/2013 12:03:18 PM
Volt, it was a fasting blood sugar (hadn't eaten for at least 10 hours). Does that matter? I know the 5.6 isn't considered high, but it's pretty close to the pre-diabetes range from what I've been reading (which is 5.7-6.4). So combined with the Glucose reading, it's slightly disconcerting. Thanks for your help.

~SuburbanMom~
Wannabe FNPea!

PeaNut 82,318
April 2003
Posts: 10,228
Layouts: 35
Loc: In my garden

Posted: 3/3/2013 12:07:10 PM
I would be more concerned with the a1c level. I would reduce the amount of breads and carbs I was eating. Make an appt. with a dietician to review your diet.


Uploaded with iPhone client

voltagain
OklaPhoma

PeaNut 18,334
July 2001
Posts: 38,143
Layouts: 15
Loc: State of cultural confusion. Yeehaw and Aloha have collided!

Posted: 3/3/2013 12:07:37 PM
I don't think you have anything to be worried about to be honest. I am a diabetic. My doc wants my fasting numbers to be between 80 and 125 in the morning.

I find it hard to believe the numbers we are shooting for in treatment are still in the prediabetes range.


What Your Kit Lens Can Do For You

Canon 60d, Canon 24-70mm 2.8L, Canon 70-200mm 2.8L, 50mm 1.8, 28-80, 75-300mm and Tamron 90mm 2.8 macro

TREZmom
Lost and Found in Pea-land

PeaNut 138,098
March 2004
Posts: 6,558
Layouts: 2
Loc: NC but wishing I was somewhere else

Posted: 3/3/2013 12:18:41 PM
Thank you SuburbanMom and Volt. This is a big relief. I do tend to get worked up over these things. That being said, I'm not going to just disregard this information and I will try to reduce starchy foods and increase my fiber/veggies. That should help me with my weight loss goals too.

Darkangel090260
PeaFixture

PeaNut 308,882
April 2007
Posts: 3,515
Layouts: 15

Posted: 3/3/2013 12:24:59 PM
your fine. My first A1C was over 9.0 and it takes a long time to go down. if your worried about becoming diabetic then lower your carb and keep working out.


I have quite a few learing disabilitys that effect my spelling a grammer. I do know my grammer and spelling suck. I have been working on this problem all my adult life.

Carolina Girl 71
Knee deep in the water somewhere

PeaNut 217,388
August 2005
Posts: 5,395
Layouts: 0
Loc: Some Beach, Somewhere

Posted: 3/3/2013 12:31:57 PM
A1C is more important than a one time blood sugar reading. A1C is the average of your blood sugar over the past three months. The 114 blood sugar could reflect what you ate for dinner the previous night, if you had a lot of carbs.

You need to look at controlling your carbs, something like South Beach diet would be good for that.


"I am in a dress, I have gel in my hair, I haven't slept all night, I'm starved, and I'm armed! Don't *mess* with me!" Gracie Hart, Miss Congeniality

"NSBR is a place where some horses are never dead enough that they can't be dragged out of the closet for one last beating." Elaine, 6/18/11


BergdorfBlonde
Getting blonder every day

PeaNut 162,956
August 2004
Posts: 10,715
Layouts: 0
Loc: LI girl, livin' in the gulf

Posted: 3/3/2013 12:45:36 PM
DH has been a type 2 diabetic for over 30 years. He claims it's in his family (it *is* but I'm convinced it was due more to weight/diet). He was on massive amounts of Metformin and was supposed to watch his diet + keep tabs of his bloodsugar levels. He lost over 60 lbs 2 years ago thru the Dukan Diet, and was able to come off of ALL his diabetes meds. Other great side effects were that his sleep apnea went away, his cholesterol was in check, his blood pressure was great and his heart was doing well!). The diet eliminated sugar and concentrated on lean proteins, non-fat yogurt and dairy, veggies and eventually whole grains (limited). I'd speak to someone who's familiar with nutrition, but if you want to research it yourself, it's easy. Cut back on sugars and carbs and keep getting your blood sugar tested.









peapermint
Ancient Ancestor of Pea

PeaNut 9,321
January 2001
Posts: 9,572
Layouts: 0
Loc: all up in your business

Posted: 3/3/2013 12:58:29 PM
DH and I had physicals a few months ago and both of our blood glucose came up at 100 and the doctor gave us a stern lecture. I also heard (nothing solid; just enough to make me nervous) that a level that high could flag us with a pre-existing condition for insurance purposes.

The doctor told us we needed to change our diets and lose more weight.

KristinL16
Ancient Ancestor of Pea

PeaNut 142,870
April 2004
Posts: 13,238
Layouts: 102
Loc: MN

Posted: 3/3/2013 1:47:49 PM
I had gestational diabetes with my last two pregnancies. When I had my follow up visit my fasting blood glucose was about what yours was. They considered that to be prediabetic. All of my other numbers were good ( I had a two hour test). They told me to come back in a year, follow the GD diet and check my blood sugar a few times a week. If anything gets worse to come back sooner.


Uploaded with iPhone client

moveablefeast
do justice, love mercy

PeaNut 265,707
June 2006
Posts: 12,559
Layouts: 0
Loc: Northern Virginia

Posted: 3/3/2013 1:54:07 PM
If it was a fasting reading first thing in the morning, it may be normal for your blood sugar to be somewhat elevated. Some people have higher readings in the morning, even though they are fasting, because your liver stores glycogen and drops it into your bloodstream as glucose overnight. Mine is always high in the morning and goes down in the hours after breakfast.

My doctors are most interested in what my blood sugar does after eating a normal meal. I am predisbetic and take Metformin, and have PCOS. An A1C of 5.6 would be perfectly desirable for me.

I would not fret. But it never hurts to watch your diet and eat more whole and healthful foods.

OKtrae
AncestralPea

PeaNut 131,500
February 2004
Posts: 4,797
Layouts: 15
Loc: Owasso, OK

Posted: 3/3/2013 2:07:17 PM
Hmmm. My A1c was 4.9 and my endocrinologist's PA put me on metformin and said to consider myself diabetic. Thinking I may need to request new bloodwork since the metformin is making me feel all woozy and my home testings are getting lower and lower.


Uploaded with iPhone client

tuesley
PeaNut

PeaNut 544,547
February 2012
Posts: 13
Layouts: 0

Posted: 3/3/2013 2:08:11 PM
I was diagnosed with blood glucose intolerance (pre diabetes) with a fasting test of 101. It IS on my insurance so be careful. I would get it down by myself if I could before getting more tests done. You might be able to get it under 100 just by changing your diet or losing a little weight.
Uploaded with iPhone client

TREZmom
Lost and Found in Pea-land

PeaNut 138,098
March 2004
Posts: 6,558
Layouts: 2
Loc: NC but wishing I was somewhere else

Posted: 3/3/2013 2:09:38 PM
Thanks for sharing your experiences everyone. This is definitely reassuring.

I didn't know this:


If it was a fasting reading first thing in the morning, it may be normal for your blood sugar to be somewhat elevated. Some people have higher readings in the morning, even though they are fasting, because your liver stores glycogen and drops it into your bloodstream as glucose overnight. Mine is always high in the morning and goes down in the hours after breakfast.


This is very helpful information.

~SuburbanMom~
Wannabe FNPea!

PeaNut 82,318
April 2003
Posts: 10,228
Layouts: 35
Loc: In my garden

Posted: 3/3/2013 3:07:21 PM
OKtre- 4.9 is not diabetic.

Trezmom - your A1c is a good level for someone with diabetes, but it would concern me in someone who is not diabetic.



justalittletike
AncestralPea

PeaNut 434,313
August 2009
Posts: 4,506
Layouts: 26

Posted: 3/3/2013 3:27:53 PM
Kristenl16- GD is different numbers for diabetic during pregnancy but you are at a higher risk after.

I failed my 1 hr miserably but passed my 3 hr fasting.


Uploaded with iPhone client

TREZmom
Lost and Found in Pea-land

PeaNut 138,098
March 2004
Posts: 6,558
Layouts: 2
Loc: NC but wishing I was somewhere else

Posted: 3/3/2013 3:33:14 PM

Trezmom - your A1c is a good level for someone with diabetes, but it would concern me in someone who is not diabetic.


See this is the problem I was having. The data is open to different interpretation, depending on who looks at it. That being said, I plan to follow through on my plan to lose weight, increase my activity level and reduce carbs/sugars and fatty foods from my diet. Hopefully that will do the trick.

peapermint
Ancient Ancestor of Pea

PeaNut 9,321
January 2001
Posts: 9,572
Layouts: 0
Loc: all up in your business

Posted: 3/3/2013 3:37:53 PM

I was diagnosed with blood glucose intolerance (pre diabetes) with a fasting test of 101. It IS on my insurance so be careful. I would get it down by myself if I could before getting more tests done. You might be able to get it under 100 just by changing your diet or losing a little weight.


When DH and I tested at 100, it had been after fasting (for a blood panel for the physical.) I hate to sound like a conspiracy theorist, but I'm paranoid that our insurance company encouraged us to get the physicals just so it could ferret out things to red-flag us on.

Regardless, we could both stand to lose some weight and cut back on sugar and unhealthful foods.

smcl
PeaAddict

PeaNut 526,836
November 2011
Posts: 1,089
Layouts: 0
Loc: Beautiful HB, Southern CA

Posted: 3/3/2013 5:47:04 PM

our insurance company encouraged us to get the physicals just so it could ferret out things to red-flag us on.


I'm with you, they probably did!


~Susan






TREZmom
Lost and Found in Pea-land

PeaNut 138,098
March 2004
Posts: 6,558
Layouts: 2
Loc: NC but wishing I was somewhere else

Posted: 3/3/2013 5:48:16 PM
I'm just glad I got life insurance a few years back. These levels would likely affect my premiums.

Heckofagal
BucketHead

PeaNut 319,348
May 2007
Posts: 532
Layouts: 1

Posted: 3/3/2013 6:25:35 PM
My fasting blood sugar is also consistently over 100, but my a1c was 5.4.

What is considered 'normal' reading for 1 hour after a meal?

KristinL16
Ancient Ancestor of Pea

PeaNut 142,870
April 2004
Posts: 13,238
Layouts: 102
Loc: MN

Posted: 3/6/2013 1:49:18 PM

Kristenl16- GD is different numbers for diabetic during pregnancy but you are at a higher risk after.

I failed my 1 hr miserably but passed my 3 hr fasting.



In case I wasn't clear, I was diagnosed with gestational diabetes when pregnant but diagnosed with pre-diabetes in April, 2012 when he was about 6 months old. I had to take insulin (and yes, I did follow the diet). After I had my son I was encouraged to take a 2 hour glucose tolerance test to make sure that the diabetes was gone. I had also started to test my BG in the mornings and it was usually high 90's or between 100-115. When I had that 2 hour test my fasting BG was 106 (just looked at my chart online) but the readings after drinking the glucose drink were fine (90 after 2 hours). I was still diagnosed with pre-diabetes. My A1C when pregnant was 5.2. At that 2 hour test several months later it was 5.6 A few weeks ago I was tested and it was 5.0. Fasting was 98. Did not have a 2 hour test that time. They have 4.0-6.0 listed as the normal range for A1C.

For the person that said it may be normal for some people to have elevated fasting BG--I am curious if that is still linked to developing diabetes in the future?

Volt--my understanding is the same as the OP's was. Fasting BG should be under 100 to be in the normal range. Between 101-125 is considered pre-diabetic. This is copied from my online results.


GLUCOSE, FASTING 106 MG/DL
Fasting diagnostic criteria(ADA/WHO):
Diabetes: >=126 mg/dL
Impair fasting gluc: 100-125 mg/dL
Normal: <100 mg/dL
GLUCOSE, 2 HOUR 90 MG/DL
Two hr diagnostic criteria (ADA/WHO):
Diabetes: >=200 mg/dL
Impaired gluc tol: 140-199 mg/dL
Normal: <140 mg/dL



leftturnonly
Will trade mosquitoes for cookies.

PeaNut 416,788
March 2009
Posts: 22,257
Layouts: 0
Loc: Living in Kim's Perfect World, again.

Posted: 3/6/2013 1:55:49 PM

Do you think the Nurse Practitioner is negligent, by not informing me of the pre-diabetes?


Not giving a patient enough information about their diabetes and how to care for it is a really hot button for me, so I was ready to jump on your Dr. But, I don't think they did anything wrong with the numbers you have.

If you are concerned, you can follow the suggestions made on this thread and see if your numbers improve. If they do, then maybe you could go back to the Dr. and tell him/her that you would have appreciated them telling you what more you could be doing to have lower blood sugar overall. It might help them know what to say to the next patient.






If PC is the way to get to Heaven, I'm going straight to Hell.



KristinL16
Ancient Ancestor of Pea

PeaNut 142,870
April 2004
Posts: 13,238
Layouts: 102
Loc: MN

Posted: 3/6/2013 2:23:53 PM
Did they do a glucose tolerance test as well or just fasting?

I personally would look into it further, especially If they didn't do a glucose tolerance test as well. Obviously some doctors do diagnose people with prediabetes when they have numbers similar to yours. Better to be proactive than to wait until it gets worse. My only hesitation with that is the insurance issue. But I still think you need to know what your blood sugar is doing after you eat.


Uploaded with iPhone client

SmartyPants71
MTB Pea

PeaNut 53,328
October 2002
Posts: 6,323
Layouts: 2
Loc: Bellaire, TX

Posted: 3/6/2013 2:39:30 PM

My A1c was 4.9 and my endocrinologist's PA put me on metformin and said to consider myself diabetic.

This makes no sense to me. If your HbA1c was 4.9, I think that makes your average bg in the high 80s which is in the normal range.


SmartyPants71
MTB Pea

PeaNut 53,328
October 2002
Posts: 6,323
Layouts: 2
Loc: Bellaire, TX

Posted: 3/6/2013 2:45:03 PM

Some people have higher readings in the morning, even though they are fasting, because your liver stores glycogen and drops it into your bloodstream as glucose overnight.

A non-diabetic will not have dawn phenomenon because someone with a full functioning pancreas will be able to compensate for the release of cortisol, glucagon, etc.

Emanon
PeaAddict

PeaNut 530,985
November 2011
Posts: 1,236
Layouts: 0

Posted: 3/6/2013 3:16:08 PM
And yet here we see again the phenomenon that I have seen played out time and time again. You get information from your doctor, and instead of asking them questions or seeking a second MEDICAL opinion, you come here and ask a bunch of people, who for the most part don't have any medical training beyond their own personal healthcare (no offense) and ask if your doctor is wrong.

If you don't like what your doctor is telling you - find another doctor.

MommaHo
AncestralPea

PeaNut 89,251
June 2003
Posts: 4,137
Layouts: 107
Loc: Ohio

Posted: 3/6/2013 3:16:45 PM
Check out your local YMCA - our local Y offers a 9 week course for both Pre and Diabetic with a specialist nurse, dietician and a few others. We are in our 6 week of the class - my husband was diagnosed on 12/23/12 and they allow the 'caretaker' to come to the class as well! It really helps with menus, exercise and just networking with others who are in the same situation.


Linda - aka MommaHo/Grams
Creativity is intelligence having fun! Albert Einstein

TREZmom
Lost and Found in Pea-land

PeaNut 138,098
March 2004
Posts: 6,558
Layouts: 2
Loc: NC but wishing I was somewhere else

Posted: 3/6/2013 4:04:29 PM

And yet here we see again the phenomenon that I have seen played out time and time again. You get information from your doctor, and instead of asking them questions or seeking a second MEDICAL opinion, you come here and ask a bunch of people, who for the most part don't have any medical training beyond their own personal healthcare (no offense) and ask if your doctor is wrong.


My PCM has been pretty much unreachable for consultation and I don't know if she will do anything more (so I don't know if I should make an appointment). But I see your point and will probably get a second opinion. OTOH, she is a Nurse Practitioner, so I'm assuming she works with a Physician. I will probably escalate this problem, to get more clear answers.


Did they do a glucose tolerance test as well or just fasting?


I've only had a fasting glucose tolerance test.



A non-diabetic will not have dawn phenomenon because someone with a full functioning pancreas will be able to compensate for the release of cortisol, glucagon, etc.


I didn't know this. Thanks for the information.


Check out your local YMCA


Good idea. I'll check into it!

melissa
O-pea-gyn

PeaNut 4
February 1999
Posts: 15,184
Layouts: 228
Loc: NJ

Posted: 3/7/2013 8:16:21 AM
If I saw those numbers, I would not say you were pre-diabetic, but you should still consider it a warning sign and do what needs to be done. You could say "pre- pre-diabetic."

I'll echo those who say you don't need to find a new caregiver or a second opinion. You might want to try stopping reading more into your lab results. Something MANY of us are guilty of and something that is hard to do! LOL

Losing the extra weight will often make a difference. I've seen it happen in myself in the past. Notice I said past though. I lost 12 lbs this fall, watched my cholesterol and triglycerides plummet low enough that I could come off the meds (also changed my breast cancer meds which may have had an effect), but my hemoglobin A1c continues to creep up as do my insulin levels despite my changes. Thanks for posting this. It's a nice motivational reminder for me too!



moveablefeast
do justice, love mercy

PeaNut 265,707
June 2006
Posts: 12,559
Layouts: 0
Loc: Northern Virginia

Posted: 3/7/2013 8:25:25 AM

A non-diabetic will not have dawn phenomenon because someone with a full functioning pancreas will be able to compensate for the release of cortisol, glucagon, etc.


My endocrinologist told me otherwise. I am not diabetic, although because of my PCOS it is assumed that I have some level of insulin resistance.

I tracked my blood sugar for a while at my endocrinologist's request, and found that I would routinely get up in the morning having not eaten for 12 hours and with a blood sugar in the 130s - to have it drop into the 70s-80s and stay there all day shortly after breakfast. I never have a rise above 120 after eating, even after eating sugary foods, and I'm always back at my normal range within a couple of hours of eating.

I explain that to say that my body functions normally with regard to energy metabolism, and yet I normally have a rise in my blood sugar in the mornings. This is normal for me, and my endo and I do not believe that it is a risk factor for diabetes beyond any other factors that I may have.

zombie*grrl
WHO PUT A DICK IN THIS BOX?

PeaNut 281,551
October 2006
Posts: 5,246
Layouts: 0

Posted: 3/7/2013 10:25:14 AM
My fasting blood sugar has never been below 120, yet my A1c puts me firmly in the non-diabetic camp.

I've had gestational diabetes requiring insulin twice, and my doctor keeps a close eye on me.

The best thing you can do for yourself is to keep your weight under control. I have in the past let my weight creep up on me and it makes a big difference in my numbers. When I'm at ideal weight, my numbers (cholesterol, BS, etc) all fall in line with that.

So, take it as a warning if you like but it's nothing to freak out about.
Show/Hide Icons . Show/Hide Signatures
Hide
{{ title }}
{{ icon }}
{{ body }}
{{ footer }}