Need to clarify diabetes prevention

[Ruthiejb]

I've been reading a lot about how losing weight, exercising and eating low carb foods can help prevent diabetes.  But what about peoiple who are already normal weight, have exercised their entire lives and already eat low carb.....what if they have a higher than normal a1c (in the prediabetes range)?  What can they do?  In other words, is it true that you can't beat your genes?  If it's in your family and you're doing all the right things and still have prediabetic test results, you won't be able to prevent diabetes from eventually developing? .

[Ruthiejb]

Just reporting that with eating lower carb foods and testing my blood sugar to see which foods I need to avoid, my A1c has gone from 5.9 to 5.6.  I feel that testing myself has really helped to determine which foods I should eliminate or drastically cut back on, such as pasta, which raised my blood sugar to 170 and kept it high for a few hours.  I've totally eliminated pasta from my diet as well as white potatoes and my A1c has improved.

[ln245611]

Hi, My name is Lynn and I have diabetes. Just recently I got my blood sugars under control. My last A1C was 5,8 which is in the normal and no risk for complications. The best advice I can give is watch your diet. Eat low carbohydrates and good healthy meals. Sometime eating sugary foods and deserts can raise you blood sugar and bring on many complications.
Diabetes can bring on many problems without warning. If you carefully watch your diet, you will do fine. Meds always helps to0  

[Ruthiejb]

Thanks so much, WaveRider.  You've been amazingly helpful.

[WaveRider]

Ruthie, I think at this point you should ignore the A1c levels. Instead put your focus on keeping normal postprandial and bedtime levels. Best put by nursegirl, "My advice remains the same, for you to continue what you're doing as far as your health is concerned, and just follow up with your doctor annually."
Good luck -

[Ruthiejb]

Again, nursegirl, thank you.  I should tell you that my entire family has been going through health issues this past year which has raised my anxiety level to off the chart.  Thank you for helping to bring me down some levels.

[nursegirl6572]

I don't know how I missed this when I first read your post:

He was on high doses of steroids for ulcerative colitis which caused the condition, but he said he probably would've developed diabetes anyway, only later in life.

That's EXACTLY what I was talking about, and what I was getting at with my example about my FIL.  Something like you describe above, would NOT genetically predispose you in the same way that it would if that family member was diagnosed as a child with a congenital diabetes.  Two VERY different scenarios, very different risk factors.  Him developing DM as a result of high dose corticosteroids would NOT predispose you to diabetes.  

[nursegirl6572]

Hiya again Ruth!  Your question is an excellent one!  Considering that obesity is the leading cause of Type II Diabetes, what IF someone is of normal body weight?  

You also have to take into consideration that Type I and Type II Diabetes are REALLY very different animals in a LOT of aspects.  If your genetic history has predisposed you to Type I diabetes, that's a lot different than if your family members had Type II diabetes.  The circumstabnces behind WHY and HOW your relatives were diagnosed is very pertinent too.  For instance, my father-in-law had severe Type I DM as a result of a very severe infection he had in his late teens.  That kind of circumstance isn't going to predispose his offspring like other causes would (i.e., being Dx'd as a child).  It was an unfortunate outcome of the infection.

You are right, to a point that you cannot "beat" genetics, so to speak.  what you HAVE done, however, is drastically reduce your chances of becoming diabetic with your healthy lifestyle choices, and proactive approach regarding your health.

I've already told you, that honestly, from everything you've posted, you sincerely have very little to be concerned about at this point.  I do understand your concerns about the A1C, but overall, it's really not a worrisome result.  Your doctor was not at all concerned, and from your readings at home, it seems that really, right now, you are okay.

My advice remains the same, for you to continue what you're doing as far as your health is concerned, and just follow up with your doctor annually.  If your anxiety remains high about this, you could always talk to an endocrinologist (you may see one for your thyroid?).  I think an Endo would be able to put your mind at ease a little more, and put a lot of this into perspective for you.  I certainly appreciate your concern about this, but I honestly feel a lot of it is a bit disproportionate to the actual concern.

Keep us in the loop!  :0)

[Ruthiejb]

Hi WaveRider, Thank you for your response.  I do have a non functioning thyroid; I've had it for the past 3 years and take 50 mcg Synthroid daily which keeps my TSH in the normal range.  I have a fraternal twin who does not have this issue, nor does anyone else in my family.  As far as insulin, as part of the new sophisticated NMR testing, I had a Metabolic panel done where my fasting insulin was tested.  The result was 3 uU/ml (optimal range is 3-9).  I'm not sure what that tells me, though.  I'm all for having those other tests but I don't think my doctor will go for it.  My A1c was tested at a national outside lab, plus it's very close to my last A1c which was done about a year ago.  Last year's was 5.8, this time it is 5.9.  Both pre-diabetic.  As far as being in my family, my material grandmother had diabetes, neither parent has it, but my brother does.  He was on high doses of steroids for ulcerative colitis which caused the condition, but he said he probably would've developed diabetes anyway, only later in life.  I don't know if that's true necessarily.  Anyway, I'll continue to do my best with my diet and exercise and if things progress in the wrong direction, I'll talk to my doctor about doing additional testing.  His response to my 5.9 A1c is that "it's acceptable".   I do appreciate your information and advice, WaveRider.

[WaveRider]

A family history of diabetes can result with a diabetes gene being passed to the next generation by one or both parents, in rare cases from the grandparents skipping a generation. The problem area lays with the actual genetic testing as it's still not fully comprehended or in place.

In your case, Ruthie, if you wish further analysis I suggest you get your thyroid and pancreas checked. A malfunctioning thyroid will disrupt pancreas insulin production. For the pancreas you want an insulin test to see how much insulin your pancreas is producing. Also, a C-Peptide test to monitor insulin production in your ßeta cell. Google islet and ßeta cell insulin production for more details.

Lastly, have you inquired with your doctor where the A1c test measurements came from? His/her office? Outside lab? How often equipment are calibrated? There is always that chance that your blood sample got mishandled or was performed on uncalibrated equipment. Instead of beating yourself up why not get another A1c?