Worried about Test results

[Koolau]

Neither my PCP nor Cardiologist were concerned when my A1C was between 5.8 and 6.1 Since losing weight (changing diet) I'm at 5.4 A1C but fasting glucose is still in the upper 90s. No concern by my "team." Doctors disagree on stuff like this but 5.8 is just barely over the limit and 88 is great. I wouldn't worry, but maybe cut some carbs and see what happens.

How about Triglycerides? That may be more instructive about carb intake. (I'm no expert - my docs were always more concerned about the TriGs than A1C. I've lowered them to "normal" with diet.) YMMV

 

[DrRoy]

I have been prediabetic for 15 years. Current A1C 5.5, BMI 22.5. You can do a lot from reducing sugar and simple carbs in your diet. Also, you can get at home A1C tests so you don't have to go to the doctor every time.

 

[Aerides]

You have to consume a good bit of chicken, fish and Greek yogurt to get 100 grams per day. I use a whey protein shakes with berries and almond milk to increase my intake.

I know, it's hard! To gain muscle, in addition to working out with weights, you really want at least a gm of protein per pound of body weight. And if you are eating 1500 calories a day, it means you really have to load protein into every meal. Shakes, yogurt, and protein powder are really a great way to help get there.

 

[Surewhitey]

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.

Did this & dropped from 7 to 5.9 in 4 months. I'm trying to find a balance of still enjoying life through food. Also some veggies are high carbs, just "better than" sugars. Sugar is my drug of choice.

 

[mystang52]

OP: I wrote a too-long reply, but deleted it and will just say this: My cardiologist wanted me to work on my then 5.9 A1C. After 18 months or so, I got it down to........5.8. Cardiologist has not repeated his suggestion. My GP told me the 5.8 is fine for my age, especially since like you I exercise virtually every day, and am not overweight. I did cut out daily sugary treats, but I will treat myself at least once a week.

 

[Amethyst]

Some athletes will have very slightly elevated A1Cs due to the stress (it's good stress, but still stress) of workouts. Prolonged workouts can cause a sort of temporary insulin resistance. It's not considered a problem, but you can see slight elevations in A1Cs.

Many countries set the "pre-diabetes" cutoff at 6.0 rather than 5.7.

A keto diet is probably not the best choice as they actually increase insulin resistance a bit and are often associated with increased saturated fat intake.

This is interesting, thanks. I suffered a bad injury last year, and spent the rest of 2024 (as soon as I got off crutches and PT) working out as hard as I could nearly every day to regain strength and mobility. Hence the insanely low body fat for my age (and way lower than in previous years). Maybe there is a connection, though I will bet my doctor never heard of it.

 

[Amethyst]

A CGM could be interesting to try, to see how you react to different foods. I’ve used the Stelo device and it’s easy to use. That would give you more insight to your glucose levels over time and should give let you know if you need to be concerned, or what foods to avoid, etc.

Can it be worn on an inconspicuous part of the body? I've only ever seen them on the upper arm, and I don't want people asking questions at the gym (and they will).

 

[Amethyst]

OP: I wrote a too-long reply, but deleted it and will just say this: My cardiologist wanted me to work on my then 5.9 A1C. After 18 months or so, I got it down to........5.8. Cardiologist has not repeated his suggestion. My GP told me the 5.8 is fine for my age, especially since like you I exercise virtually every day, and am not overweight. I did cut out daily sugary treats, but I will treat myself at least once a week.

I can deal with sweet treats once a week, I think.

 

[street]

Always something wanting to get us. I wouldn't be concerned with your number on glucose.
I'm at ~ the same age you are and have a BMI of 23 and my glucose number was 92. Doc said nothing about it and was concerned. You have got me interested to look back over my ten-year record for glucose and see what the history shows.

If concerned I would retest in a few weeks like others have said.

 

[wolf]

OP. Been a diabetic for over 20 years. Type 2. Stop worrying. Your numbers are "excellent." Seems over the past few years, The MD guidelines have changed. Everyone I know has "suddenly" become Pre-diabetic.
Not sure why they have "lowered" the numbers for diabetes.

Don't forget. They are saying "Pre-diabetic". Not you are a Diabetic. I think I read somewhere, only a very small percentage of pre-diabetic people become Diabetic.

 

[DEC-1982]

I have watched some videos of the lady known as "Glucose Goddess". She is a French biochemist. She has recommended a few things to reduce blood sugar spikes after meals. DW and I follow her recommendations.


1. Eat vegetables and plants first, then proteins and then starch
2. Walk after meals
3. Ankle raises
4. Drink apple cider vinegar with the "mother"

We drink this vinegar 30 minutes before dinner.
I think any activity, not just walking, will do.

 

[AllDone]

This is interesting, thanks. I suffered a bad injury last year, and spent the rest of 2024 (as soon as I got off crutches and PT) working out as hard as I could nearly every day to regain strength and mobility. Hence the insanely low body fat for my age (and way lower than in previous years). Maybe there is a connection, though I will bet my doctor never heard of it.

Here's a study for your doc:

Glycaemic control in athletes - PubMed

Physical activity is essential for weight control, for limiting onset and complications of chronic disorders and for preventing impaired insulin sensitivity. Little is known about the glycaemic adaptations of physically active subjects, especially elite and professional athletes. Thus, we...

pubmed.ncbi.nlm.nih.gov

They found that elite cyclists had slightly higher A1Cs than sedentary schlubs. You're fine. If your A1C was 5.8, you were sedentary and had a roll around your middle, there would be more concern. Your doc is used to seeing the latter category (and probably falls into it himself).

You don’t need to chase "blood sugar spikes" with a CGM. They’re 100% normal. Your body has a built in management system for them. (Blood sugar that rises and stays elevated is the problem.) Healthy carbohydrates are very nutritious and cutting them out of your diet is unnecessary. Low carb diets can lead to other problems and doesn’t make any more sense than giving up exercise. Vinegar is bad for your tooth enamel and useless for your blood sugar.

 

[Rianne]

I have read alot about effects of ketosis on kidneys and have come to the conclusion that it does. Obviously, out of control diabetes damages kidneys even more.

Is Losing Weight Worth Losing Your Kidney: Keto Diet Resulting in Renal Failure - PMC

Keto diet is defined as a high-fat, adequate-protein, and low-carbohydrate nutrition which forces the body to burn fats and use an alternative metabolic fuel resource by stimulating endogenous ketone production. The standard range of ketones in ...

pmc.ncbi.nlm.nih.gov

Yes, I have severe kidney disease, not from diabetes. Mine is rare, Nephrogenic diabetes insipidus. Has nothing to do with sugar diabetes but with kidneys not responding to ADH. I've been to Mayo Clinic for this. My treatment, lots of water...60++ oz/day. Mediterranean diet, low protein, low salt, high vegetable, dairy, eggs. I eat very little meat (almost none). All my blood work is normal, sugar levels, A1C, nutrients, except eGFR, creatinine. BUN. There are so many things that cause kidney disease. Medicines, ibuprofen taken on a daily basis, prescription drugs, dehydration...many things people are not even aware of.

My first cousin took ibuprofen for pain, the recommended dose for about 10 years. She has severe kidney disease from this...eGFR @ 20 and has been living this way for a long time. She watches her diet very carefully, again low protein, lots of water, low salt.

 

[audreyh1]

I have watched some videos of the lady known as "Glucose Goddess". She is a French biochemist. She has recommended a few things to reduce blood sugar spikes after meals. DW and I follow her recommendations.


1. Eat vegetables and plants first, then proteins and then starch
2. Walk after meals
3. Ankle raises
4. Drink apple cider vinegar with the "mother"

We drink this vinegar 30 minutes before dinner.
I think any activity, not just walking, will do.

What are ankle raises?

 

[braumeister]

I have read alot about effects of ketosis on kidneys and have come to the conclusion that it does. Obviously, out of control diabetes damages kidneys even more.

Is Losing Weight Worth Losing Your Kidney: Keto Diet Resulting in Renal Failure - PMC

Keto diet is defined as a high-fat, adequate-protein, and low-carbohydrate nutrition which forces the body to burn fats and use an alternative metabolic fuel resource by stimulating endogenous ketone production. The standard range of ketones in ...

pmc.ncbi.nlm.nih.gov

The study cited in that reference was about one person who had been on an extremely high protein diet for two months. It's well known that very high protein intake can be damaging, and has little to do with a well formulated ketogenic diet.

 

[pacergal]

Amethyst-
I think you are fine.
But, I would ask for another test, make sure you are fasting for 12 hours. it won't affect the A1c, as that is a basic measurement over 3 months, but will give you an accurate FBS.
Also, a urine test for a hidden UTI. Women, as we age, can get them with very little symptoms, urinary frequency may be the only one.
However, urinary frequency is also a signal for diabetes.
I have worked with many healthy, active folks over the years with sudden diabetes diagnosis.
It can happen.

I have been pre diabetic for years, A1c always at 5.8-5.9. I started metformin only because diabetes runs heavily in my family.

 

[RetiredHappy]

OP. Been a diabetic for over 20 years. Type 2. Stop worrying. Your numbers are "excellent." Seems over the past few years, The MD guidelines have changed. Everyone I know has "suddenly" become Pre-diabetic.
Not sure why they have "lowered" the numbers for diabetes.

Don't forget. They are saying "Pre-diabetic". Not you are a Diabetic. I think I read somewhere, only a very small percentage of pre-diabetic people become Diabetic.

Acutally pre-diabetic numbers between 5.7 to 6.4 has been there for decades. More doctors are prescribing a1C tests, and talking about it with their pateints now.

I first realized that I might be pre-diabetic was when I took my blood sugar after a meal of meatballs and spaghetti at Old Spaghetti Factory about 18 years ago and it was 170. Non-diabetics should not spike beyond 140 two hours after a heavy carb meal. I spoke with my PCP immediately and he said "Everyone is pre-diabetic, it is how you manage your diet, and then whether you die first or become diabetic first." If you do nothing about your lifestyle, it takes about 10 years to go from pre-diabetic to diabetic.

I am still pre-diabetic and have cut out most sugary treats. I have never drunk sugar sodas or fruit juices, so sugared drinks isn't the issue. The issue is that I love my carbs and having to consciously control each day is a constant challenge. So, I eat a very small portion of potatoes, rice or pasta, Pizzas that I do indulge in are the Cauliflour pizzas from California Pizza Kitchen, very thin and low in glycemic index, and without any tomato sauce on it. We get them at the restaurant through their Take and Bake (Sausage and mushroom) and split one with my husband. He is diabetic type 2 for about 27 years now. He manages it well and not progressed on to Type 1. In his case, it is also called diabetic type 1.5 (LADA - Latent Auto Immune Diabetes in Adults) as he has autoimmune that is attacking his pancreas.

 

[DEC-1982]

What are ankle raises?

The correct term is calf raises.
although it looks to me like the ankle is raised

Push up onto the toes of your feet, and then back down.

 

[Rianne]

The study cited in that reference was about one person who had been on an extremely high protein diet for two months. It's well known that very high protein intake can be damaging, and has little to do with a well formulated ketogenic diet.

There is nothing wrong with a well formulated Keto diet if you have healthy kidneys.

The Effects of High-Protein Diets on Kidney Health and Longevity - PMC

Although high-protein diets continue to be popular for weight loss and type 2 diabetes, evidence suggests that worsening renal function may occur in individuals with—and perhaps without—impaired kidney function. High dietary protein intake can cause ...

pmc.ncbi.nlm.nih.gov

"For patients with existing kidney disease, the diet’s high protein intake may accelerate the progression of their kidney disease.64 For individuals without kidney disease, there is limited evidence suggesting that these diets pose danger. However, data from several prospective studies show that animal protein—an integral part of many ketogenic diets—may increase the risk of developing CKD.19,20,50,51

Of equal concern for those without CKD is the high amount of fat in the ketogenic diet. Lin et al.19 showed a higher risk of albuminuria among study participants in the highest quartile of animal fat consumption compared with those in the lowest quartile. In another study, Lin et al.20 demonstrated that a dietary pattern that included higher saturated fat intake is also associated with an increased risk of albuminuria and eGFR decline. In addition, studies have demonstrated a protective effect of many foods that are often excluded from the ketogenic diet, including fruits, vegetables, legumes, and whole grains.65 Exclusion of these foods from the diet may represent an opportunity cost of potential health benefits for the kidney."

 

[audreyh1]

The correct term is calf raises.
although it looks to me like the ankle is raised

Push up onto the toes of your feet, and then back down.

Thanks, I was wondering if it was calf raises. How are calf raises supposed to provide a metabolic benefit? Is it calf raises after a meal?

You are using both your calves and your ankles to accomplish that move. Pushing up onto your toes engages your calves.

 

[DEC-1982]

Thanks, I was wondering if it was calf raises. How are calf raises supposed to provide a metabolic benefit? Is it calf raises after a meal?

You are using both your calves and your ankles to accomplish that move. Pushing up onto your toes engages your calves.

I am mainly trusting the recommendations of Dr Jessie Inchauspé.

But to answer your question, this is what I got out of Google:

Calf raises, also known as soleus push-ups, can help with blood sugar spikes by:

Improving insulin sensitivity: Making cells more responsive to insulin, which helps with glucose uptake
Improving blood circulation: Helps transport glucose and oxygen to cells throughout the body
Burning sugar: The soleus muscle uses glucose for energy, which lowers blood sugar levels
Increasing caloric expenditure: Helps with weight management and reducing the risk of insulin resistance

 

[DEC-1982]

Thanks, I was wondering if it was calf raises. How are calf raises supposed to provide a metabolic benefit? Is it calf raises after a meal?

You are using both your calves and your ankles to accomplish that move. Pushing up onto your toes engages your calves.

I forgot to add that yes, I do them after eating meals.

 

[audreyh1]

Yes, my impression is that healthy leg muscles (which are large muscles) really help overall insulin sensitivity. Thanks for the info.

 

[imjustawarrior]

Get one of these and train him to expect a walk after every meal. He will keep you honest even in the foulest weather.

 

[Koolau]

Lots of advice and sources of medical opinions here regarding diabetes, diet, exercise, supplements, protein, etc. How is one to know what to choose from the "menu" of ideas?

Perhaps I'm too trusting, but my PCP and Cardiologist are satisfied with my numbers and I'm taking that to mean I'm doing things (if not exactly correctly) well enough.

None of us gets out of here alive.