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Old 11-06-2013, 05:57 AM   #1
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False security in 'safe' words...

This has bothered me for awhile, so I'm just going to put it out there...

45 years ago I was a hypoglycemic and the medical community was still teaching that this was the opposite of diabetes. Now we know that it is an indicator that the person has the diabetes gene and has the potential to develop diabetes.

I see this same thing happening with this idea of telling people they have 'pre-diabetes', as if this is somehow not diabetes...yet...and I think doctors are doing their patients a disservice. Here's why...

The majority in the diabetic community believe in the following:
  • An A1c of 5.2 or lower is considered healthy and normal (although a fair number believe it's an A1c of 5)...which means an average BG over 3 months would be around 108 (at 5.2) or 96 (at 5).
  • Pre-diabetes starts at 5.4 or 5.5 to 6.5 (some disagreement on this) with BG's averaging at 115-119 to 154.
  • A diagnosis of diabetes is given at an A1c of 6.5 with BG's of 154.

If normal is 5 or 5.2 and below, and someone is running higher than that, they aren't 'pre-' anything. They're outside the normal range *consistently* which indicates they are in the *beginning* stages of diabetes.

I think telling someone they're pre-diabetic gives that person a false sense of security. It doesn't really prepare them for the reality that unless they have *tight* control (see Dr. Bernstein's "Diabetes Solution"), they will progress to higher BG's. Delve deeper into some of the diabetic studies and you find that it is 'expected' that once a person starts taking oral meds, they will gradually progress to higher doses and/or injectable insulin over time. Two things on this...
  • Tight control, as far as Bernstein goes, is eliminating all but non-starchy vegies in order to reverse the insulin resistance and continuing this diet so the insulin resistance does not return (leading to higher BG's)
  • It is not surprising the concensus is that 'pre-diabetics' will progress to more meds to control their BG's over time since the diet recommended for them is still a diet way too high in carbs for diabetics (or pre-diabetics :/ ).

One last thing. THERE IS NO CURE FOR DIABETES. I go nuts when I see someone say they 'used to be' a diabetic or they 'reversed' their diabetes. Uh yeah...NO...you didn't. THERE IS NO CURE. All you've done (and congratulations) is to control it with your diet. Go back to eating the way you did before and, over time, you'll once again have high BG's and a higher A1c. Normal people (those without the diabetic gene) can eat all the garbage they want, get as fat as they want and be as lazy as they want and will still never develop diabetes...and some people have eaten a healthy (per the ADA even) diet, maintained a proper weight and lead active lifestyles and they still develop diabetes.

My dad was diagnosed as a pre-diabetic 53 years ago. He's a very disciplined man and immediately went on the ADA diet, lost the 20 pounds he needed to lose, and continued with his active lifestyle. He had a very physical job in the steel mill, plus he played handball twice a week, but to that he added an hour of exercise (built a gym in the basement) 7 days a week. Despite that, over the years his A1c has gone progressively higher until now he's on insulin. When my dad complained over the years to his endo (3 different ones), they said this was normal but he should congratulate himself that he wasn't on insulin sooner.

So call it pre-diabetes if you must, but the reality is that if you have an A1c of 5 (ok...5.2 if you want to stretch it), there's no 'pre' about it. You are a diabetic in the beginning stages of diabetes and it will progress 'naturally' if you don't keep tight control of it.

<kicking soapbox back under table>
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Old 11-06-2013, 07:17 AM   #2
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Quote:
Originally Posted by Aomiel View Post
Normal people (those without the diabetic gene) can eat all the garbage they want, get as fat as they want and be as lazy as they want and will still never develop diabetes...and some people have eaten a healthy (per the ADA even) diet, maintained a proper weight and lead active lifestyles and they still develop diabetes.
I've had to accept this as my truth. Twenty-five or so years ago as a young very very thin active person I was told I was hypoglycemic. At the time it meant nothing to me because over the years I continued to stay thin and felt healthy. When I turned 43 years old I began to gain weight and my bs went out of control. So here I am at the age of 46 trying to reign it in and lose 25 or so pounds.
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Old 11-06-2013, 07:17 AM   #3
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"One last thing. THERE IS NO CURE FOR DIABETES. I go nuts when I see someone say they 'used to be' a diabetic or they 'reversed' their diabetes. Uh yeah...NO...you didn't. THERE IS NO CURE. All you've done (and congratulations) is to control it with your diet. Go back to eating the way you did before and, over time, you'll once again have high BG's and a higher A1c."

Wow Aomiel, that was an awesome post and to comment on the above paragraph, it's the same as being and alcoholic. There is no cure, you go back out drinking and it's as if you have never stopped. You are back right where you left off and progressively get worse.

I think it was Dr. Perlmutter, Grain-Brain, who also agrees with your view of "pre-diabetes" and the disservice it's doing to those who have been given that diagnosis.

I feel that the only way for me to keep this "pre" from progressing to full blown diabetes is to stay on a low carb diet. By doing so it keeps my so called diabetes genes in "remission" so to speak, and by going to AA meetings, that keeps my alcoholic genes in "remission".
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Old 11-06-2013, 01:00 PM   #4
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What a great post just the kind of kick in the pants I need. I've been kidding myself that because I was 'only prediabetic' and my numbers were good last time, that I could be off plan for the last four months without damaging my health. Well, 10kg later and here I am again, the sad thing is that it wa the concern about my weight rather than my health thats been my biggest motivator. Thanks again, this is just what I needed to read.
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Old 11-06-2013, 01:13 PM   #5
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I tend to disagree with some of these 'facts.' All my siblings are Type 2, and I have always been concerned about developing it. I'm hypothyroid, and I have regular labs every 4 months. My A1C is typically 5.2-5.4--and my endo considers that 'perfect.' Keep in mind that it has remained at this level for over 6 years (that I've been regularly tested). IMO, it's the consistency that my endo finds positive. I am 72, and I eat very low carb, but my former endo ordered a Glucose Tolerance Test several years ago (when I was obese) because she was concerned that I might be 'controlling' with diet. The GTT indicated that I have no problems with blood sugar.

As for being 'cured,' my sister had WLS and is now totally controlled without meds. Her doctor told her that there ARE case of gastric bypass patients being 'cured' of Type 2 (she had gastric sleeve) and the test is to do a Glucose Tolerance Test to see how the individual handles sugar. The claims that have been made that gastric bypass can 'cure' Type 2 have been based on patients who have been seriously tested. That is the only WLS that has produced that result to date.

And, yes, there is a lot of misinformation about the 'cure' for diabetes, even within the medical community. My sister recently had a colonoscopy, and the nurse who discussed her medical history told her that since she no longer needed meds, she was 'cured' of her Type 2. My sister tried to explain that she was not 'cured' but 'controlled,' but the nurse insisted she was wrong!
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Old 11-06-2013, 02:22 PM   #6
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Not trying to be contrary. But, the medical doctor on Biggest Loser just last night specifically said that diabetes is reversible and that most of the contestants on the show are able to stop all their meds, test in normal ranges, etc. He is a doctor and he calls it reversed. Maybe it would be better to think of it in terms of "in remission." But, if you take the test and you don't meet the criteria for the disease...you no longer have it. It's just semantics, really...reversed, remission, cured, better, healthier, whatever you want to call it.
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Old 11-06-2013, 04:07 PM   #7
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I'm calling it "under control" since I know from personal experience that low carbing lowered all my numbers, and after a few months of higher carb eating, all my numbers started climbing again. It's not gone, just under control, as long as I keep my carbs low.
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Old 11-07-2013, 11:38 AM   #8
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But, if you take the test and you don't meet the criteria for the disease...you no longer have it. It's just semantics, really...reversed, remission, cured, better, healthier, whatever you want to call it.
The Biggest Loser doctor (and I'd hesitate to believe anything anyone associated with that type of show says) goes against what the diabetic community (endo's, diabetes clinics, even diabetes assoc.) says. There is no cure for diabetes. All you can do is control it. Reversed, cured, in remission...sorry, they are not the same thing as 'controlling' it. Ok...remission might, but then it's not the same thing as reversed or cured. Ask someone with leukemia.
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Old 11-07-2013, 11:45 AM   #9
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Originally Posted by Leo41 View Post
I tend to disagree with some of these 'facts.' All my siblings are Type 2, and I have always been concerned about developing it. I'm hypothyroid, and I have regular labs every 4 months. My A1C is typically 5.2-5.4--and my endo considers that 'perfect.' Keep in mind that it has remained at this level for over 6 years (that I've been regularly tested). IMO, it's the consistency that my endo finds positive. I am 72, and I eat very low carb, but my former endo ordered a Glucose Tolerance Test several years ago (when I was obese) because she was concerned that I might be 'controlling' with diet. The GTT indicated that I have no problems with blood sugar.

As for being 'cured,' my sister had WLS and is now totally controlled without meds.
Leo,
I don't know anything about the changes that a bypass makes so I won't address that, but the endos I go to do not even use a GTT as they believe it is an inaccurate indicator for diabetes. More important is the A1c because it tells what you've been averaging over a period of time.

Your endo is in disagreement with the diabetes community if she considers 5.4 normal as that is considered pre-diabetic. However, I'm not going to argue about it or even debate it because there is some disagreement on a lot of this in the diabetes community.

As for staying at 5.2-5.4 for 6 years, understandable if you've been low carbing. Something to think about though...if you're VLC it seems like your A1c is kind of high if 'normal' is 5.2 (or 5) or below. Do you know what level of carbs will increase your BG's?
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Old 11-07-2013, 11:52 AM   #10
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Originally Posted by haferchamp View Post
I'm calling it "under control" since I know from personal experience that low carbing lowered all my numbers, and after a few months of higher carb eating, all my numbers started climbing again. It's not gone, just under control, as long as I keep my carbs low.
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Old 11-10-2013, 05:56 PM   #11
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Aomiel!! What a wonderful post!!


I was hypoglycemic for YEARS before diagnosis, but I did not take it seriously and am paying the costs now.

I will say this much, from the moment your medical file has "diabetic" on it, trust me ALL insurance companies will consider you a diabetic, I don't care how good your a1c is. You can control it with diet for 25 years, insurance companies and medical community will tell you right quick.. You have diabetes, you might control it, but it is there. Any person who thinks differently is in for a rude awakening.

Again, GREAT POST!!
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Old 11-12-2013, 05:39 AM   #12
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I will say this much, from the moment your medical file has "diabetic" on it, trust me ALL insurance companies will consider you a diabetic, I don't care how good your a1c is. You can control it with diet for 25 years, insurance companies and medical community will tell you right quick.. You have diabetes, you might control it, but it is there. Any person who thinks differently is in for a rude awakening.
Yes, I had completely forgotten this. When you go to apply for insurance. They don't ask if you're diabetic. They ask have you *ever* been diagnosed with diabetes.

Also, if they do ask 'are you' and you say 'no'...and they discover your past medical records had you diagnosed as diabetic, they can use that as grounds for nullification of your life insurance...but they'll happily collect your premiums until you go to collect.
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Old 11-12-2013, 05:36 PM   #13
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Aomiel.....such a great post. Thank you for putting this out there. My A1C is 5.6 and I thought that was normal. I have the hardest time staying on low carb and I really needed this post to stay focused on this. I do not want to be diabetic and know that I am very close. I see that your A1C is 4.9...wow..how impressive....that will be my goal. Thank you for posting this....it's real.
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Old 11-12-2013, 07:59 PM   #14
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Mine was 6.1 when diagnosed and after 3 months of low carb eating it was down to 5.1. So yes it does work!
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Old 11-12-2013, 09:35 PM   #15
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Aomiel.....such a great post. Thank you for putting this out there. My A1C is 5.6 and I thought that was normal. I have the hardest time staying on low carb and I really needed this post to stay focused on this. I do not want to be diabetic and know that I am very close. I see that your A1C is 4.9...wow..how impressive....that will be my goal. Thank you for posting this....it's real.
I've ALWAYS strayed from low carb, because I was addicted to carbs (mainly) I was addicted to starches.

For me it is no longer about the gazillion lbs I need to lose. So this isn't a diet for me this time. If I lose weight that is just an extra added bonus. For me, when I see someone else eating a baked potato, I don't crave it like I used to and if I think about "maybe just one bite". I have been making myself to the mental picture.. "starchy poison on one side" vs "amputated limb" on the other. I know it sounds extreme, but man it has really been a big deterrent. I know I am only 3 months in since diagnosis, but so far, that has really helped me.

Good luck on your journey!
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Old 11-12-2013, 09:36 PM   #16
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Mine was 6.1 when diagnosed and after 3 months of low carb eating it was down to 5.1. So yes it does work!
WTG!! YEAH!!
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Old 11-13-2013, 03:23 AM   #17
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Mine was 6.1 when diagnosed and after 3 months of low carb eating it was down to 5.1. So yes it does work!
Inspirtational! I am waiting for results of latest A1c test. Do any of you drink diet sodas? Does that effect your BS? I am definitely a carb addict.
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Old 11-13-2013, 05:07 AM   #18
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Inspirtational! I am waiting for results of latest A1c test. Do any of you drink diet sodas? Does that effect your BS? I am definitely a carb addict.
Good luck on your a1c, I was so excited waiting for mine last week!

I don't drink any diet sodas. I do, however, drink at least a gallon of tea each day and I put 1/4 cup splenda in a gallon tea pitcher. It doesn't seem to have any effect on my b.s's. Going from 6.9 to 5.8 was pretty exciting. Now that I am calmed down, lol... I'm upset it wasn't lower, because I was DILIGENT, almost to the extreme. But at least it is going in the right direction.
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