Worried about Test results

Amethyst

Give me a museum and I'll fill it. (Picasso) Give me a forum ...
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Dec 21, 2008
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I would like to ask for the forum's insights and advice.

Just turned 68, had my yearly blood tests, and the lab results, which appeared the next day, were a shock. I'm prediabetic (A1C 5.8, fasting glucose 88). I've always had normal fasting glucose, and this is the first time the doctor ordered an A1C for me, so I have no idea how long it's been too high. I understand that the A1Cis a better indicator, as a snapshot of the last 3 months rather than just the day before.

My family history: I never heard that either mom or dad had diabetes, nor saw anything that could be considered diabetic "symptoms." I would have heard about it, if they had. However, my 2 older siblings, obese and sedentary, have been on T2 diabetes medication for many years. Both are in very poor health.

I'm thin (BMI 20.1), very active (many hours a week of cardio, resistance, stretching, plus I do my own housework and yardwork), lean (14% bodyfat, 4% visceral fat). I eat a lot of vegetables, and avoid ultra-processed food. The only thing I've noticed (and it's not that big of a change) is that I do seem to go to the bathroom more often.

The doctor's office has scheduled me to see him in a month. Medication, if any, will depend on whatever AMA algorithm he uses. He may want more tests. I fully expect to hear about exercising more and eating more vegetables, controlling my stress (yeah, right), etc. Given I already do those things to a great extent, what additional insights are out there?

Thanks,

Amethyst
 
Other members are much more knowledgeable, but the first thing I would do is retest. The bathroom frequency thing is normal as we age.
 
I am not a doctor. But my A1C has been above 6.0 for many years. I know it is not good, but ...
 
Agree with MichaelB on the retest.
The increasing bathroom frequency is typically more of a concern with males and their prostrates.
 
One thing I’ve learned about tests is that you can’t rely on the averages or range that they give you. The results are individual and need to be interpreted combined with your specific nature. Please don’t get worried until you talk with your doctor.

Remember, averages and ranges include everyone. So someone with your numbers that’s overweight and inactive may indeed be marching toward diabetes. Given your stated activity level and diet, I doubt you have anything to be concerned about. You are not the typical patient.
 
From the land of alcohol and refined sugar, your fasting glucose is something I'd almost consider on the low side. I'm usually hovering around 100. But then, I'm not a doctor.
 
Agree with MichaelB on the retest.
The increasing bathroom frequency is typically more of a concern with males and their prostrates.
Yes, have to agree on the bathroom stuff. also, my A1C jumped from 5.1 to 5.7 last year with no changes in anything I do or eat @81 years old. Go figure! Doc said I am pre-diabetic, but I seriously doubt it with fasting glucose around 90. He is not concerned with my readings.

I have two friends my age who have A1C's between 7 and 10 and they take a med (metformin).

Get a retest on the A1C and fasting glucose for sure.
 
At this point, I wouldn't stress over your A1C result. I suspect a retest will solve the issue. One last comment, according to my lasted addition Biochemistry text, A1C is impacted the most by glucose levels two weeks prior to testing, which would place it right in the middle of the holiday season. ;) .

.... The amount of glycated hemoglobin (GHB) present at any time reflects the average blood glucose concentration over the circulating lifetime of the erythrocyte (about 120 days), although the concentration in the two weeks before the test is the most important in setting the level of GHB......
 
Never had a problem with fasting glucose, even when I took meds in the past to treat acute conditions where it had to be monitored.

But as part of pre-surgical tests last year my A1C (first time testing) was over 7.

Started Monjuaro, & I find the GI side effects...unpleasant...but that dropped A1C to under 5.

Will meet with a new doctor next month & see what it is then.
 
As others have suggested, I'd get a second opinion/re-test. I've been tracking my fasting blood sugar for 20+ years and every couple of years I get a number that is way off. If you want some peace of mind and have access to Quest Diagnostics in your area you can order an A1C for about $30 from Jasonhealth.com or ultalabtests.com. If the re-test shows you're normal then I would bring the results to the next doctors appointment.
 
A1C of 5.8 is just barely in the pre-diabetic range. Fasting glucose of 88 is excellent. If one does nothing to change their diet and exercise, it takes about 10 years to become diabetic. You should not have any symptoms with those numbers.

If I were you, I would add more protein, and reduce high carb vegetables. Consuming more vegetables won't help your blood sugar.

I have been pre-diabetic for easily 20 years, but through diet, I have not progressed on to being diabetic. My weight is in the normal range although I would like to lose 10 pounds.
I try to keep my A1C to under 5.6.
 
5.8 is just barely pre-diabetic. I wouldn't worry too much about that.

I was at 5.8. I have spent 1.5 years trying to lower it through weight loss, better diet, and more exercise. I have managed to drop it to 5.6.

I might get a Stelo CGM to see if I can get my A1C lower.
 
Maybe you can glean some nuggets of help here:


If you tested just after the holiday season (land of terrible foods), maybe there is some after shock effect.
 
DH is there at borderline pre with A1C of 5.6 to 5.8. His glucose was always just a little bit high, which is why he had the doctor start doing A1Cs.

However he eats quite a low carb diet, is normal weight, very active every day and generally in excellent health. All his carbs come from vegetables and some fruit. No junk food, no desserts/sweets, no grains. So we don’t worry about it. Dr isn’t worried about it.
 
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I do eat sweets. I'm an excellent baker, and I eat and share what I make. In particular, I make killer pizza. Hope I don't have to give up those few indulgences - I don't have many others.
 
I’m not medical professional, but I spent 30 years selling diabetes products, glucose meters, A1C meters, diabetes meds.
You have no concerns, almost zero. Fasting glucose under 100 is not in diabetic range. A1C of 5.8 is no issue. If it’s under 5.5 you are not pre-diabetic. Very few peps with pre-diabetes convert to diabetes. Obviously, some do but not many.
American Diabetes Association describes type 2 as A1C over 6.5. Fasting glucose over 125.
In fact I’d refuse therapy if I were you. Should the doctor offer.
What I would do is add weight lifting to your fitness routine. Specifically heavy lifting. Weights that really strain you. It causes your body to use stored glucose and increase insulin sensitivity.
Likely your doctor is In “cover your a** mode”. He/she needs to document they discussed the ramifications with you.
 
I would like to ask for the forum's insights and advice.

Just turned 68, had my yearly blood tests, and the lab results, which appeared the next day, were a shock. I'm prediabetic (A1C 5.8, fasting glucose 88).

Thanks,

Amethyst
I don't know if you want to make lifestyle changes.

Switching to keto diet will most likely drop your A1C. YMMV.
 
5.8 is just barely pre-diabetic. I wouldn't worry too much about that.

I was at 5.8. I have spent 1.5 years trying to lower it through weight loss, better diet, and more exercise. I have managed to drop it to 5.6.

I agree with this. I'm like you- 20 BMI, very active, eat healthy 99% of the time, lots of vegetables and not a lot of meat. (Yeah, I know- a friend reversed his Type 2 diabetes with a keto diet but his was severe and I prefer to avoid meat most of the time for other health reasons.) No family history or other risk factors. My fasting glucose clusters around 100 and last year the two times I've tested a1c it was 5.7 each time. In 2023 it was more like 5.2-5.3. No doc has ever suggested medications. I monitor it and tweak my diet if it gets too high. Just tested again this morning but won't get results for a couple of days. (I use RequestaTest and pay out-of-pocket- reasonable cost, no surprise bills.)

I dealt with more frequent urination at night but am now (1) using Premarin cream twice weekly to keep the membranes Down There from getting dry and irritated, (2) taking a cranberry powder supplement and (3) making sure if I get up in the middle of the night to empty it all out rather than hopping back into bed ASAP. Not sure which of these worked but I'm down to maybe on trip per night. Hope that's not TMI.

That a1c is worth monitoring but not time to panic.
 
Keto is good.
Removing all refined carbs will reduce your glucose, if you want to live that way.
I was diagnosed pre-diabetes 10 years ago. I’m not skinny, always been a weightlifter. I increased my weights and frequency, gained 10 pounds, all fat, not on purpose, trying to loose it. My A1C dropped out of pre-D range. But once you have the diagnosis you always have it.
Reducing refined carbs and heavy weights is the ticket for me.
 
I’m not medical professional, but I spent 30 years selling diabetes products, glucose meters, A1C meters, diabetes meds.
You have no concerns, almost zero. Fasting glucose under 100 is not in diabetic range. A1C of 5.8 is no issue. If it’s under 5.5 you are not pre-diabetic. Very few peps with pre-diabetes convert to diabetes. Obviously, some do but not many.
American Diabetes Association describes type 2 as A1C over 6.5. Fasting glucose over 125.
In fact I’d refuse therapy if I were you. Should the doctor offer.
What I would do is add weight lifting to your fitness routine. Specifically heavy lifting. Weights that really strain you. It causes your body to use stored glucose and increase insulin sensitivity.
Likely your doctor is In “cover your a** mode”. He/she needs to document they discussed the ramifications with you.
Thanks for your insights. I agree that resistance exercises are important for all sorts of reasons. Have lifted as heavy as I can tolerate since I was 34 years old, at least 3x a week for all the major muscle groups.
 
‘Pre’ diabetes implies there will be a general trend towards full blown T2 diabetes without some kind of intervention.

A single HgA1c reading of 5.8 can not inform on trend nor on individual variations to the highly generalized guidelines. For instance, the threshold for ‘prediabetes’ in the UK is 6.1.

I recommend reading the linked blog entries of nutritionist/researcher, Dr Nicola Guess.

She deals mainly with athletes but much of what she writes applies the veracity/quality of nutrition research.

Prediabetes is an umbrella term for at least two separate conditions (impaired fasting glucose/impaired glucose tolerance) that describes blood glucose which is higher than normal but not high enough to meet the threshold for a diagnosis of type 2 diabetes (T2D). Prediabetes is the term generally used because it serves as a bit like an alarm bell that a person is at increased risk of T2D.
Although some non-modifiable factors increase a person’s risk of developing T2D, changes in our lifestyles are the largest contributor to the T2D epidemic. At least 80% of people with T2D have a BMI >25kg/m2, and physical activity is inversely related to T2D risk.


 
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Keto is good.
Removing all refined carbs will reduce your glucose, if you want to live that way.
I was diagnosed pre-diabetes 10 years ago. I’m not skinny, always been a weightlifter. I increased my weights and frequency, gained 10 pounds, all fat, not on purpose, trying to loose it. My A1C dropped out of pre-D range. But once you have the diagnosis you always have it.
Reducing refined carbs and heavy weights is the ticket for me.
Refined carbohydrates (e.g. homemade cookies and bread) are just about the only indulgence I have. I don't eat huge amounts but I do enjoy some, most days. Haven't had a sugary drink since my mid-teens.
 
I agree with this. I'm like you- 20 BMI, very active, eat healthy 99% of the time, lots of vegetables and not a lot of meat. (Yeah, I know- a friend reversed his Type 2 diabetes with a keto diet but his was severe and I prefer to avoid meat most of the time for other health reasons.) No family history or other risk factors. My fasting glucose clusters around 100 and last year the two times I've tested a1c it was 5.7 each time. In 2023 it was more like 5.2-5.3. No doc has ever suggested medications. I monitor it and tweak my diet if it gets too high. Just tested again this morning but won't get results for a couple of days. (I use RequestaTest and pay out-of-pocket- reasonable cost, no surprise bills.)

I dealt with more frequent urination at night but am now (1) using Premarin cream twice weekly to keep the membranes Down There from getting dry and irritated, (2) taking a cranberry powder supplement and (3) making sure if I get up in the middle of the night to empty it all out rather than hopping back into bed ASAP. Not sure which of these worked but I'm down to maybe on trip per night. Hope that's not TMI.

That a1c is worth monitoring but not time to panic.
Hardly TMI! I bet it is super common. I wasn't even worried about my once-a-night get-ups, until I read that it can be a warning sign. Cranberry is out for me (sadly) because it's an acid trigger for GERD/LPR, which I'm trying to manage without meds. I haven't had a cup of coffee or a tomato (sob) in a year or more.
 
Lots of good advice here - no need to add to the solid recommendations you've already received.

What I would strongly recommend you do is use a CGM for a limited amount of time to determine how YOU react to the foods you eat. There is huge individual variation in how people react to the same foods...some have huge spikes to a food that others barely show a blip of a rise to. Armed with this information you can make decisions on what to eat and/or avoid to minimize glucose spikes. And yes, an individual's response to foods can change as we age as the pancreas can become less "robust".

Someone mentioned Stelo (which is essentially a DEXCOM CGM), which you can get without a prescription for less than $100 for 2 x 2 week sensors.

Dr. Peter Attia has explained that an A1C reading represents the area under the curve of glucose level measured over time. A higher level, if accurate, is less healthy. I agree that a 5.8 reading isn't the end of the world, but if you're interested in learning why and making adjustments to improve it, a CGM is the way to go.

Good luck!
 
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