I think I'm now pre diabetic, not sure what to do?

[philalethes]

Glucagon is the key factor in the development of diabetes

The authors of this paper make some interesting assertions about the role of glucagon in the development of diabetes:

“Glucagon excess, rather than insulin deficiency, is essential for the development of diabetes for several reasons. Glucagon increases hepatic glucose and ketone production, the catabolic features of insulin deficiency. Hyperglucagonaemia is present in every form of diabetes. Beta cell destruction in glucagon receptor null mice does not cause diabetes unless mice are administered adenovirus encoding the glucagon receptor. In rodent studies the glucagon suppressors leptin and glucagon receptor antibody suppressed all catabolic manifestations of diabetes during insulin deficiency. Insulin prevents hyperglycaemia; however, insulin monotherapy cannot cure diabetes such that non-diabetic glucose homeostasis is achieved. Glucose-responsive beta cells normally regulate alpha cells, and diminished insulin action on alpha cells will favour hypersecretion of glucagon by the alpha cells, thus altering the insulin:glucagon ratio. Treating diabetes by suppression of glucagon, with leptin or antibody against the glucagon receptor, normalised glucose level (without glycaemic volatility) and HbA1c. Glucagon suppression also improved insulin sensitivity and glucose tolerance.”

I don't think artificially suppressing glucagon is going to fix the underlying problems at work here. The first thing to note is how glucagon and insulin typically have opposite roles, with the former promoting release of energy substrates and catabolism, and the latter promoting their absorption and anabolism.

Thus under circumstances of insulin resistance, I believe what happens is that the cells are lacking energy, and even with blood sugar being high and insulin being present, the insulin resistance leads to the sugar not being shuttled into the cells as one would want. This would lead to continued catabolism and release of glucose from the liver to hopelessly attempt to feed the cells, but to little avail. Thus you get the chronically catabolic hyperglucagonemic state described.

Suppressing glucagon in that situation would certainly be helpful, there's no denying that, since it's not achieving what it's supposed to at all, but the underlying problem of insulin resistance remains to be solved, even if it is somewhat mitigated by the all the glycative stress from the hyperglucagonemic state.

 

[jet9]

Intermittant fasting and lower your carbs. I'm NOT saying fast for days or eliminate carbs, I'm saying fast for at least 12-14 hrs a day every day. I lost 29 pounds in 3 months (all the weight gain started of course with eating lots of carbs) and haven't felt this good in many years. All my insulin resistant symptoms went away - hypoglycemia, not feeling full no matter how much I ate, hungry again shortly after I ate, carb cravings, etc. - all gone. My pre-diabetes symptoms also went away - constant thirst, frequent urination, super dry eyes, kidney pain, etc. Doing this won't take long to start showing solid results - give it a week, but you need to maintain it for as long as you want the benefits.

What are typical meals for you?

 

[ubiety]

What are typical meals for you?

2 meals a day, so mainly larger portions (organic and/or grass fed as much as possible) of meat, eggs, cruciferous veggie (with butter/olive oil), salad (like kale, arugula, a little spinach - w/balsamic vinegar, etc - never the mostly water lettuce), some fruit with 1 meal. If I'm extra hungry I'll add a little organic pasta (gluten free as much as possible) or sourdough bread with butter. Sometimes a little hard cheese, beans, or lentils. A small piece of chocolate.

 

[helpmyhair]

Does this make any sense? This Lifestyle Libra 2 device measuring my glucose levels, is showing my levels at around 6.7mmol/L before eating but the last few times I've eaten, my blood sugar actually lowers in the half an hour following. So for example I had a little snake last night, my glucose reading went from 6.8 before, gradually down to 5.1 in the following half an hour, before then rising back up to about 6.0 an hour later. A moment ago, I just went to the gym (I manage it about 3 days a week currently) just a short few sets of weights, no cardio which I can't tolerate. I got home had a whey protein shake. Before the shake my glucose reading was 6.7, 5 mins after the shake it was down to 5.9, 10mins down to 5.7, 15mins down to 5.4, 20mins down to 4.9mmol/L.

What the hell is going on? Surely that's the opposite of what should typically happen?

I can help you make sense of this as I also wear a Libre 2. First thing is that it'll take 1-2 days to get stead accurate readings with the Libre. Btw, if your blood glucose was 6.7 before eating anything (without snakes in the last few hours),then you might be Type 2 Diabetic. Would consult with a doctor regarding that.

As for working out, any physical activity that exerts some energy will cause your blood sugar to start going down. I am particularly sensitive to it and just the walk to my gym which is very close can make my sugars fall. So your blood sugar going down after a work out makes sense.. just make sure you are eating after a workout so it doesn't fall too low. Although I have heard some people say that weightlifting can make their blood sugar go up, but I have not experienced that. Mine almost always goes down after a workout

 

[helpmyhair]

Cyrus Khambatta and Robby Barbaro of Mastering Diabetes and all the people they've helped is clear evidence that this isn't true, even in the case of T1 diabetes; they both have it. They demonstrate clearly how you can reverse insulin resistance even in T1 diabetes with a diet that is extremely high in carbohydrate.

I have actually listened to that podcast. Yes it does work when all your carbs are coming from fruits.. thats what this guy did, he was primarily only eating fruit. Heavier carbs like breads, pastas, rice, etc. will definitely require a ton of insulin to combat hyperglycaemia

 

[AlaskaJono]

I too was given the 'Pre-Diabetes" Hypoglycaemic diagnosis in 1983 as a young man of 19 years. I took the sugar test because of badgering from my mom, as she thought I might have it. After about 3 weeks of feeling sub energetic young man levels, I just dropped the whole thing. Boom. Excercise regularly, eat whole foods, simple foods, that I cook, and included meat/carbs/fat. When I wanted to have sugar, I had fruit or juice. I found that protein and fat are like ballast for sugar, so eat dessert After the meal. Many years later I discovered Chromium GTF, and it did seem to help some friends who were seemingly affected by the sugar levels. Also I was an Acupuncturist at this time, and I did study nutrition as well. Watered down juice while you work out can help with spikes or dips. Good luck.

 

[Callmestar]

I can help you make sense of this as I also wear a Libre 2. First thing is that it'll take 1-2 days to get stead accurate readings with the Libre. Btw, if your blood glucose was 6.7 before eating anything (without snakes in the last few hours),then you might be Type 2 Diabetic. Would consult with a doctor regarding that.

As for working out, any physical activity that exerts some energy will cause your blood sugar to start going down. I am particularly sensitive to it and just the walk to my gym which is very close can make my sugars fall. So your blood sugar going down after a work out makes sense.. just make sure you are eating after a workout so it doesn't fall too low. Although I have heard some people say that weightlifting can make their blood sugar go up, but I have not experienced that. Mine almost always goes down after a workout

Thanks. So that particular Libre 2 stopped working after 3 days. Perhaps it was faulty. They've sent me another one which seems to give me lower readings. I compared both to blood glucose test strips. The first Libre I had seemed to give higher readings than the blood test strips, and this new libre seems to give lower readings lol. This libre is at times showing my blood sugar down in the low 3's (hypo) and I don't feel at all hypo. Starting to wondering if the devices are accurate at all but as you say it may take a few days to be more accurate so i'll wait.

The blood test strips glucose monitor is showing my morning fasting blood sugar at around 5.7- 5.9 thus far, so that's a bit less concerning but equally is not ideal and still indicates some prediabetes/insulin resistance. The libre 2 is giving lower readings than that, so around 5.0 in the morning. My blood sugar the rest of the day, also actually seems to lower than in the morning, outside of meals. So a hour or two after meals according to the libre it's down to about 4.7 - 5.0 with some random peaks up to six and some random peaks down to 3..0 (which I don't necessary think is accurate, because I haven't felt hypo at all since having the new device). I don't know what to think to be honest. I've got some more blood test strips coming tomorrow so will keep comparing but thus far I've completely lost faith in the libre, it's all over the place.

 

[AspiringSage]

Thanks. So that particular Libre 2 stopped working after 3 days. Perhaps it was faulty. They've sent me another one which seems to give me lower readings. I compared both to blood glucose test strips. The first Libre I had seemed to give higher readings than the blood test strips, and this new libre seems to give lower readings lol. This libre is at times showing my blood sugar down in the low 3's (hypo) and I don't feel at all hypo. Starting to wondering if the devices are accurate at all but as you say it may take a few days to be more accurate so i'll wait.

The blood test strips glucose monitor is showing my morning fasting blood sugar at around 5.7- 5.9 thus far, so that's a bit less concerning but equally is not ideal and still indicates some prediabetes/insulin resistance. The libre 2 is giving lower readings than that, so around 5.0 in the morning. My blood sugar the rest of the day, also actually seems to lower than in the morning, outside of meals. So a hour or two after meals according to the libre it's down to about 4.7 - 5.0 with some random peaks up to six and some random peaks down to 3..0 (which I don't necessary think is accurate, because I haven't felt hypo at all since having the new device). I don't know what to think to be honest. I've got some more blood test strips coming tomorrow so will keep comparing but thus far I've completely lost faith in the libre, it's all over the place.

Get a more traditional meter and compare results.

 

[helpmyhair]

Thanks. So that particular Libre 2 stopped working after 3 days. Perhaps it was faulty. They've sent me another one which seems to give me lower readings. I compared both to blood glucose test strips. The first Libre I had seemed to give higher readings than the blood test strips, and this new libre seems to give lower readings lol. This libre is at times showing my blood sugar down in the low 3's (hypo) and I don't feel at all hypo. Starting to wondering if the devices are accurate at all but as you say it may take a few days to be more accurate so i'll wait.

The blood test strips glucose monitor is showing my morning fasting blood sugar at around 5.7- 5.9 thus far, so that's a bit less concerning but equally is not ideal and still indicates some prediabetes/insulin resistance. The libre 2 is giving lower readings than that, so around 5.0 in the morning. My blood sugar the rest of the day, also actually seems to lower than in the morning, outside of meals. So a hour or two after meals according to the libre it's down to about 4.7 - 5.0 with some random peaks up to six and some random peaks down to 3..0 (which I don't necessary think is accurate, because I haven't felt hypo at all since having the new device). I don't know what to think to be honest. I've got some more blood test strips coming tomorrow so will keep comparing but thus far I've completely lost faith in the libre, it's all over the place.

I can definitely help you out with this.

Your first libre 2 unit probably was giving strange readings. A good libre 2 will usually give a point lower than the test strips. So if you used the test strips and get a 5.. the libre 2 usually will say its 4. I believe this is done to prevent lows. My libre 2 is always like this with the rare times of the number being the same. Generally the test strips should be the most accurate. However once I had my libre 2 read a 3.9 and the test strips say 5.5 and I was definitely experiencing hypo symptoms. Also btw, hypo symptoms you may not feel right away.. I remember being a 3.7 recently and not feeling anything.. checked with strips and it said the same. And as I was treating it, I started to feel the symptoms... so hypo symptoms can be delayed.

Another factor is that if there is pressure applied to the libre 2 sensor, it can show lower readings than actual. Somehow the pressure on the sensor makes it think the sugars are lower than they are. For example, lets say you are laying down, or sleeping on your side and the sensor under your arm is being pressed again the bed. That can make the number lower than it actually is. So thats one thing to look out for. Its good practice to check with the test strips if you get a hypo reading (less than 4) on the libre. But no need to double check if you feel hypo symptoms.. just go ahead and treat.

And yes.. first 1-2 days of a new sensor always shows inaccurate numbers. Mine show a lot lower than they actually are.

As for morning sugars, my diabetic nurse says that sugars can rise in the morning.. I forget why. Doesn't seem to make sense since you are in a fasted state, but she mentioned why it happens, I just can't remember. Doesn't always happen with me but sometimes. But if you checked with blood test strips, that would be accurate. So it makes sense that your libre 2 is showing 5.0 in the morning. I would say your actual morning sugar is 5.7-5.9, which would indicate pre-diabetes type 2. Would definitely follow up with your physician and ask for a blood test to check your A1C. That will help them determine if you are indeed pre-diabetic. If that is the case, not to worry, type 2 is reversible unlike what I have.. the dreaded Type 1. But yeah, your sugars going down 4.7-5.0 is a good sign.. but that could be due to the face you are awake and more active. Any physical activity, including walking (even around your home) will make your blood sugar drop. Another explanation is that you body makes the correct amount of insulin and you are not insulin resistant. So whatever you eat, your body makes the appropriate amount of insulin to bring your sugars back to normal range a couple hours after a meal.

I would not give up on the Libre 2. It has been life changing for me. It just takes some working out the kinks, and having a traditional meter on hand to verify when you suspect something seems off. For the first could years I used test strips and this did not paint the picture at all of how my sugars trended, how they would react to certain foods, etc. When I was on test strips, my sugars were always too high. Once I got on Libre 2, I was able to understand my body better, how it reacts and get my sugars into proper range. Also the alarms are handy especially if you aren't aware that you are having a low. Many people have lows but don't experience symptoms until its very dangerously low. The alarms have saved my life several times when I went low in the middle of the night in my sleep.

What I really want is the Libre 3, but they haven't been approved in Canada. If they are approved in your country, then I would definitely upgrade to that. It is basically the same as the Libre 2 except its a continuous glucose monitor meaning no more scanning the sensor. It automatically sends readings to your phone every minute which is pretty amazing. The form factor is also a lot smaller. There is also the Dexcom which could be an option if your insurance covers it as it is more expensive than the libre. It is also a CGM, so no scanning and I believe it has a way to calibrate it with test strips to give more accurate readings. Personally I don't like the form factor of it, but it is the industry stand blood glucose monitor and has the best software behind it. If you haven't already notices, the Libre 2 app is absolutely horrible. Scanning doesn't always work.. data is just okay, etc. If you check out the Dexcom's app, its a night and day difference. Dexcom is also coming out with their new G7 sensor which is smaller than their current G6, but not as small as Libre 3. So Libre 3 would be perfect for me, when it actually comes out in Canada.

 

[LLight]

As for morning sugars, my diabetic nurse says that sugars can rise in the morning.. I forget why. Doesn't seem to make sense since you are in a fasted state, but she mentioned why it happens, I just can't remember.

I think they refer to it by the Down phenomenon.

Dawn Phenomenon - StatPearls - NCBI Bookshelf

 

[Callmestar]

I had my Hba1c tested due to my recent blood sugars looking high and thankfully, it looks ok. The usual dehydration, frequent urination stuff continues as ever and perhaps now is showing on my kidney bloods given the high Urea result.

 

[Kyle970]

Does anyone know of an affordable place to buy a libre 2 online? (Without a dr recommendation)

 

[Risingfire]

High-dose Aspirin, B vitamins, especially B1, B2, B3 to optimise glucose oxidation.

+1 and consider thyroid supplementation

 

[LUH 3417]

I too was given the 'Pre-Diabetes" Hypoglycaemic diagnosis in 1983 as a young man of 19 years. I took the sugar test because of badgering from my mom, as she thought I might have it. After about 3 weeks of feeling sub energetic young man levels, I just dropped the whole thing. Boom. Excercise regularly, eat whole foods, simple foods, that I cook, and included meat/carbs/fat. When I wanted to have sugar, I had fruit or juice. I found that protein and fat are like ballast for sugar, so eat dessert After the meal. Many years later I discovered Chromium GTF, and it did seem to help some friends who were seemingly affected by the sugar levels. Also I was an Acupuncturist at this time, and I did study nutrition as well. Watered down juice while you work out can help with spikes or dips. Good luck.

Do you know why I would have worse hypoglycemic symptoms the week leading up to menstruation? More frequent urination at night, constant hunger, feeling dizzy and sweaty, waking up feeling SO cold and hungry. I’m especially curious from a TCM perspective what is going on besides the obvious answer of estrogen.

 

[AlaskaJono]

Do you know why I would have worse hypoglycemic symptoms the week leading up to menstruation? More frequent urination at night, constant hunger, feeling dizzy and sweaty, waking up feeling SO cold and hungry. I’m especially curious from a TCM perspective what is going on besides the obvious answer of estrogen.

Get thyself to an Acupuncturist! Pronto... . Cold feeling symptoms are usually Yang Deficiency + Qi deficiency along with frequent urination.... . Dizzy spells can be a lot of things, Blood Def. and or Wind in the Channels. Also sounds like you need some sugars and or carbs to get some energy.

(If I hazard a guess that you may have lost more blood than you make through heavy periods and or not enough red meat protein plus/or you have an iron deficiency due to years of quasi vegetarianism (only chicken for example) AND you crave chocolate, then.... I might be wrong. I don't want to guess here, so please check out your local Acu.;-)

TCM (Acu + Herbs) is fantastic for diagnosing and successful treatment of menstrual issues. It addresses heavy periods/lotsa clotting/pain -swelling/odd timings of the cycle, along with underlying (exacerbating) conditions. 33 years ago my Herbal professor Dr. Lihua Wong said that no woman ( or young woman) would suffer through difficult periods because Mom or Grandma would take them to the local Acu/herbalist to address the issue. Best regards.

 

[LUH 3417]

Get thyself to an Acupuncturist! Pronto... . Cold feeling symptoms are usually Yang Deficiency + Qi deficiency along with frequent urination.... . Dizzy spells can be a lot of things, Blood Def. and or Wind in the Channels. Also sounds like you need some sugars and or carbs to get some energy.

(If I hazard a guess that you may have lost more blood than you make through heavy periods and or not enough red meat protein plus/or you have an iron deficiency due to years of quasi vegetarianism (only chicken for example) AND you crave chocolate, then.... I might be wrong. I don't want to guess here, so please check out your local Acu.;-)

TCM (Acu + Herbs) is fantastic for diagnosing and successful treatment of menstrual issues. It addresses heavy periods/lotsa clotting/pain -swelling/odd timings of the cycle, along with underlying (exacerbating) conditions. 33 years ago my Herbal professor Dr. Lihua Wong said that no woman ( or young woman) would suffer through difficult periods because Mom or Grandma would take them to the local Acu/herbalist to address the issue. Best regards.

I agree with you and every time I have seen one I’ve had almost miraculous shifts in my cycle, complete reversal of water retention, mood issues etc. i was vegetarian for a few years so blood deficiency makes a lot of sense. Thank you for the insights.

 

[Nik665]

I got a Freestyle Libra 2 on a free trial. It's one of these blood glucose monitors that sits permanently on your arm so you can get a blood glucose reading whenever you need to.

I've had ongoing issues with ill health for several years now which I've posted elsewhere on this forum. With one of my main symptoms being extreme thirst and frequent urination, although m tests had never shown any sign of diabetes with my Hba1c always well within range. Recently though I had been having episodes where I'd start feeling very faint and weak, but also wired/simulated in the brain, so I thought perhaps it's low blood sugar along with adrenals pumping out which is making me feel stimulated. Hence I got this device to check.

I had one of the episodes of feeling faint and weak yesterday and testing my blood sugar and it was 5.8mmol/L / 104.4mg/dL, so it seems unlikely those symptoms are from low blood sugar but anyway other than the odd one of reading below 6, since using this blood glucose monitor, I can see my blood sugar even when fasting seems to sit well above 6.0mmol/L / 108mg/dL, which going by most information I can find, is classed as pre diabetes. I also wonder if i'm very sensitive to a very slight drop in blood sugar now, given the symptoms i'm having of feeling faint and weak which gradually subside somewhat after eating.

I just don't know what to do anymore. Many hear say, eat high carb, peat type foods, and they do in the short term make me feel a bit better. But equally my cholesterol is high, and my blood sugar looks to be a mess as well. My functional medicine doctor wants me to eat paleo type diet and is adamant on no orange juice etc which I said I was drinking via some of the ideas here. I do think i'm probably going to have to go paleo / low carb as I can't risk developing diabetes on top of everything else but it just seems a nightmare finding any solution or knowing what the right thing to do is.

I'm 80kg, 5'9, carry a decent bit of muscle but have a slight layer of fat over belly and chest.

Get an a1c test asap

 

[Foongbear]

High-dose Aspirin, B vitamins, especially B1, B2, B3 to optimise glucose oxidation.

Hi, I've been doing high dose B vitamins, plus calcium and around 1 gram aspirin along with Magnoil and Pyrucet from Idea Labs to correct persistent high fasting glucose.
Cortisol is 300 nmol/L (sorry for the Australian ranges on labs) and i don't feel that I'm a particularly stressed person.
Fasting glucose over 8 mmol/L
Lacate of 12 mmol/L
Ketones 0.7 mmol/L

I've had fasting insulin tested several times and it ranges 5 to 7 mU/L

I get some major glucose spikes (up to 14 mmol/L ) from carbs, even fruits taken after protein

Would really appreciate some advice on what may be worth trying to slow down the over-active gluconeogenesis.

Thank you

 

[Matt1951]

No one really knows what causes type 2, only what aggravates it. Think how bariatric surgery instantly cures type 2, even before the patients lose any weight. Bypassing part of the intestines cures diabetes. Going too low on carbs will increase your blood sugar, such as carnivore or keto, as I have experienced. Keto only reduces blood sugar if there is a large weight loss, but any diet where one loses weight will improve blood sugar. Keto would also increase uric acid, increasing the likelihood of getting uric acid kidney stones, or even gout. Get a minimum of 100 grams of carbs daily, you can cut back from where you are now, but not too far. Whole milk will be beneficial. Dairy fat is your friend.
One theory is that a combination of iron and bad gut bacteria are the root cause of type 2. So dairy is beneficial regarding not consuming too much iron. Blood donation can help.

 

[GreekDemiGod]

Hi, I've been doing high dose B vitamins, plus calcium and around 1 gram aspirin along with Magnoil and Pyrucet from Idea Labs to correct persistent high fasting glucose.
Cortisol is 300 nmol/L (sorry for the Australian ranges on labs) and i don't feel that I'm a particularly stressed person.
Fasting glucose over 8 mmol/L
Lacate of 12 mmol/L
Ketones 0.7 mmol/L

I've had fasting insulin tested several times and it ranges 5 to 7 mU/L

I get some major glucose spikes (up to 14 mmol/L ) from carbs, even fruits taken after protein

Would really appreciate some advice on what may be worth trying to slow down the over-active gluconeogenesis.

Thank you

Sorry, can’t help you here. I just mentioned what I read in the forum.
What is your macro split?