Help, or advice please, long term low carber but....
 

Hi, I'm hoping someone can help me out, I am utterly confused.
I started low carbing maybe 6 years ago or so, Atkins, then progressed to paleo as a maintenance woe.
I lost my way over the last year, a bit, and gained 2 stone (28pounds) , but got back to low carb since new year. I've only lost about 14 pounds so far. I am eating basically Atkins, aiming for 20g carbs max a day, admittedly going to 30 max now & again. Ratios are generally right. Eat meat, fish, eggs, cheese, green veg, salad (not even tomatoes) pork rinds, almond crackers that I make. Flavourings... Herbs dry spices, olive & coconut oils, black coffee, water, almond milk, diet tonic at night.
BUT.........
I had a blood screen last week, and have been asked to go and see the diabetic nurse, as I am "potentially prediabetic". I can't understand it. I don't know my exact reading yet, they wouldn't tell me by phone.
I am 5ft 7inch, currently weigh 168lb, (12 stone) I am active all day as I care for my elderly ill mum 24/6...often through the night too, though that does mean I don't get out to exercise as such... I try to grab a half hour walk most days but that's all, whilst I used to get lots more exercise before I started caring.
I take thyroxine, antihistamines for asthma, a steroid inhaler and salbutamol, and magnesium. I am 55, female. Mum is diabetic, though I got her bloods down enough to come off metformin, and she is diet controlled, yet she can eat cake, biscuits, chocolate, puddings, potatoes, you name it. Likewise my sister who is approx 21 stone (294lb) eats pizza, cake and all sorts but is fine.
I think I average about 1500 calories a day, sometimes more, sometimes less.
So, I'm baffled, upset, a little scared, and expecting to be told to eat wholegrain, pasta, lots of fruit & veg, etc etc.
I would like to go to the appointment armed with some knowledge and not have to roll over & go on a low sugar & fat carby diet.
Any help, information or thoughts would be much appreciated please.

What is "protentially pre-diabetic"?. You either are or are not in a pre-diabetic range (by standard blood work) weird they would not tell you the number...your blood, your health record. :rolleyes: Was this only a one-time fasting BG or did they test an HbA1c, an average of past 3 months? Also, by doing IF in the morning, my HbA1c went up because the natural need to add glucose when no carbs available Kept BG somewhat high until lunchtime. https://idmprogram.com/dawn-phenomenon-t2d-8/
And it could be PIR for a similar reason. http://ketopia.com/physiological-insulin-resistance/
And last, stress and lack of sleep are known reasons for Elevated BG...you have that for sure. If the number is a one-off fasting BG somewhere in the pre-Diabetes range, I would not worry and have it re-done next visit.

Thanks jey100, I'll decipher the initials and read your links tomorrow now. I had gone for a thyroid blood test, mid morning, eaten nothing by chance. She just said she might as well do all my bloods whilst she was doing that, as I'd had none done for 2 years except thyroid.

This is from my text on medical lab testing.

Diabetes Risk Factors
Overweight tendencies (BMI > 25 kg/m2
Habitual physical inactivity
Family history of diabetes in a first-degree relative
High risk minority population-African American, Latino, Native American
History of gestational diabetes or delivering a baby > 9lbs
Hypertension > 140/90

Four Methods of Diagnosis (each must be confirmed by one of the first 3 methods on a subsequent day).

1. HbA1c > 6.5% using National Glycohemoglobin Standardization Program-certified method. In patients with red blood cell destruction A1c may be falsely low.

2. Diabetes symptoms + random glucose level of > 200 mg/dL

3. A fasting plasma glucose of > 126 mg/dL, Fasting blood glucose should be obtained in the morning after 8-10 hr fast.

4. An oral glucose tolerance test (OGTT) w/2-hour post-load (75-g glucose level) > 200mg/dL. Not recommended by ADA

You may have inherited a genetic predisposition to insulin secretion, insulin resistance or both. Other specific types of type 2 are associated with genetic defects of beta cell function or insulin action, pancreatic/endocrine diseases etc.

I thought this interesting
 

Hormones that control glucose levels

A. insulin from pancreas, decreases glucose

B. Glucagon from pancreas, increases glucose

C. Epinephrine and glucocorticoids from adrenal gland, increase glucose

D. Growth hormone and ACTH from anterior pituitary, increase glucose

E. Thyroxin thyroid gland and somatostatin pancreas increase glucose

My asthma inhaler has glucocorticoids.

Interesting! Lots of reading to do then between care duties this weekend (usually get a day off at weekends from my sister, but she's declined to come this weekend) I am on Qvar inhaler and venting. Will check the Qvar, only recently ish started on that.
Thanks for your input here, very gratefully received, feeling a bit better about it all now!

And of course, not "rolling over" and deciding what foods to eat is completely in your control. Using a low carb diet in the UK is not unknown, Dr David Unwin has done a study with the Diabetes.co.uk group on LC treatment, and there is a low carb program on their website you can join.
https://www.lowcarbprogram.com

https://www.dietdoctor.com/dr-david...-diabetes-times

https://www.diabetes.co.uk

The fact that you are on steroids is a factor in insulin resistance.



Understanding how steroids affect my own "auto-immune" condition has been instrumental in me getting better. So print out the paper and bring it, perhaps? My doctor isn't intimidated by that :lol:

Jey100, ive delved into your links now, very interesting, thanks. They havent asked me to do a glucose tolerance ttest yet, looks like i'll have to do a weeks high carbs first if they do! Grrrr

And thanks werebear for that. I will indeed! It'd be good if they warned you about steroid effects, or found some other way to treat asthma and the like!
Thanks for those next links too Jey, i'm afraid i'm quite naive about diabetes and low carbing....becoming less so....i just always saw it as a good thing from a blood sugar point of view. I have more understanding already. It's never been an issue for me.
Glad i included my meds in my op, i nearly didn't.

Are you taking your own BG at home, before and after eating meals? That is probably better than a one-off blood draw.
http://www.wheatbellyblog.com/2016/...ng-blood-sugar/

Here is a newer and better explanation of the dawn phenomenon, why you might have a higher reading in early morning blood draw versus your blood sugar reaction after eating meals. https://blog.virtahealth.com/dawn-phenomenon/

And always check for side effects for every drug you are on, even OTC pain relievers have an impact. Drugs.com is a good website in the US, not sure with different brand names in UK if there is better one?

Let us know what happens...would be interesting to hear the diabetes educators reaction if you discuss Dr Unwin's work and the Diabetes.UK program.
Btw, here is a map of UK doctors using LC. https://phcuk.org/map/. I don’t see one near Leicester, but this doctor has a blog and FB page you might find useful. https://www.dietdoctor.com/member/interviews/mccormack

Thanks Janet.
No, never tested my sugar levels, never had need to!
My appointment isnt until april 16th, but i certainly will come back to you all, i do know many "diabetic nurses" dont stand by low carb diets etc, so i may have a fight on my hands. Certainly my mums nurse poopoo's it all, and dishes out the same old standard advice...even after i got mum off metformin as i now cook for her! I don't deny her stuff, just edge her meals towards lower carb.

Well, today was the day, I went armed with all your thoughts. I was pleasantly surprised to find she was human, and believes in low carb,... And paleo!
My HbA1c is 6.2. Cholesterol is fab, especially the good cholesterol, as is current thyroid TSH, And kidney function is OK too.
She agreed I can't do better with my diet, just continue to lose weight a bit more. She also agreed the thyroxine has an effect, but my inhaler has a very limited effect. She just wants to monitor me every 6 months, bloods & urine. She reckons its more likely to be genetic. Oddly, my sister, who is obese at over 22stone, (about 310lb) drinks plenty, smokes, does zero exercise and tucks into everything she fancies, has perfectly fine bg. That seems so unfair!

Hi, Hallyth. :) I'm glad you got a good report. I hope you are doing well.