I had a Ac1 in the pre diabetic range 5.8 and dropped it to 5.3 just by adding protein fat and fiber to every meal and eating carbs last during the meal. Worked for me. I was already exercising and am super skinny to begin with, with is not typical of people in the pre diabetic range. I’m glad I was able to correct it. It’s doable but you have to be mindful
Then what is insulin resistance and is that reversible? My A1C is 5.7 and my doc wants to do a 2 hour glucose tolerance test. All the data can drive you crazy after a while…
Great question. Insulin resistance is when your native insulin (made in the pancreas to digest carbohydrates) isn't working efficiently. Which then causes elevated blood sugars. I can't think of a reason to do a 2 hr glucose tolerance test when you already have data (A1c 5.7%) to show that your average sugars are higher than is ideal - but maybe your doctor doesn't trust the result?
I will answer this question in more detail on Friday. It's a great one - and highly relevant!
I’m now on Letrozole for breast cancer. I have been in the pre-diabetic range for years 5.8-6.0. Is my risk now higher since low estrogen can impact insulin resistance?
Hi Alma - are you asking about your risk for progressing to diabetes? or your risk of the high sugar levels themselves?
The risk for progression to diabetes (from normal or “pre-diabetic" range sugar/A1C levels) depends on all of the factors I listed. Being on medication that reduces estrogen levels can impact that.. but there are still many other modifiable factors to use as “levers” to help reduce risk.
I think you answered my question. A medication, such as Letrozole, that lowers estrogen levels, is another factor that can increase the risk of insulin resistance. I guess I will use that knowledge as motivation that I need to continue to work on modifying the factors I can control.
Question: what are the metabolic risk factors for A1C 5.7-6.3? Many type 2’s are told under 7 is just fine. I have a client who hovers around 6 and is developing diabetic retinopathy and has a new triple A (2.5) but is not encouraged by docs to keep it below 5.7. She also just underwent POEM SURGERY for acalacia.
You covered the risk factors for type 2. I think it is important to emphasize that the risk factors are also there for those considered pre diabetic as well. Many doctors DON’T even know this. Many docs don’t even know type 2 is reversible. Eric Westman MD is the pre eminent expert on this. He is at Duke.
LADA is type 1 that occurs later in life. It is ameliorated by eating very low carb high fat moderate protein diet and all the other life style changes mentioned above.
Two years after I developed Long COVID, I became pre-diabetic, developed high cholesterol, and my thyroid numbers began fluctuating wildly. I attribute all this to LC because for over 20 years, I’ve eaten a Mediterranean diet. And I was an avid exerciser before LC made me too fatigued and weak to continue. I’m now on metformin, and pravastatin in my 40s, with a normal weight and healthy diet.
Rice and yams are indeed starches... but I am not an absolutist when it comes to lifestyle modification. I wouldn't tell anyone to stop eating any specific food - esp if they provide other benefits! - if there are other modifiable factors in your health ecosystem to help reduce blood sugar levels..
For example, you might want to eat yams every now and then and skip the bread, pasta, cereal, wine... or increase your cardio .. or get more daily steps in a day.. or boost muscle mass... health is about trade offs, not on/off switches :)
I had a Ac1 in the pre diabetic range 5.8 and dropped it to 5.3 just by adding protein fat and fiber to every meal and eating carbs last during the meal. Worked for me. I was already exercising and am super skinny to begin with, with is not typical of people in the pre diabetic range. I’m glad I was able to correct it. It’s doable but you have to be mindful
Yes, mindfulness for the win!
Then what is insulin resistance and is that reversible? My A1C is 5.7 and my doc wants to do a 2 hour glucose tolerance test. All the data can drive you crazy after a while…
Great question. Insulin resistance is when your native insulin (made in the pancreas to digest carbohydrates) isn't working efficiently. Which then causes elevated blood sugars. I can't think of a reason to do a 2 hr glucose tolerance test when you already have data (A1c 5.7%) to show that your average sugars are higher than is ideal - but maybe your doctor doesn't trust the result?
I will answer this question in more detail on Friday. It's a great one - and highly relevant!
I’m now on Letrozole for breast cancer. I have been in the pre-diabetic range for years 5.8-6.0. Is my risk now higher since low estrogen can impact insulin resistance?
Hi Alma - are you asking about your risk for progressing to diabetes? or your risk of the high sugar levels themselves?
The risk for progression to diabetes (from normal or “pre-diabetic" range sugar/A1C levels) depends on all of the factors I listed. Being on medication that reduces estrogen levels can impact that.. but there are still many other modifiable factors to use as “levers” to help reduce risk.
Does that answer your question? :)
I think you answered my question. A medication, such as Letrozole, that lowers estrogen levels, is another factor that can increase the risk of insulin resistance. I guess I will use that knowledge as motivation that I need to continue to work on modifying the factors I can control.
Exactly - it’s another factor
What is LADA?
Question: what are the metabolic risk factors for A1C 5.7-6.3? Many type 2’s are told under 7 is just fine. I have a client who hovers around 6 and is developing diabetic retinopathy and has a new triple A (2.5) but is not encouraged by docs to keep it below 5.7. She also just underwent POEM SURGERY for acalacia.
Hi - the risk factors are the ones listed in the post here :)
Also I recorded podcast today about all…
https://lucymcbride.substack.com/p/pre-diabetes-and-metabolic-health
You covered the risk factors for type 2. I think it is important to emphasize that the risk factors are also there for those considered pre diabetic as well. Many doctors DON’T even know this. Many docs don’t even know type 2 is reversible. Eric Westman MD is the pre eminent expert on this. He is at Duke.
LADA is type 1 that occurs later in life. It is ameliorated by eating very low carb high fat moderate protein diet and all the other life style changes mentioned above.
yes!
Two years after I developed Long COVID, I became pre-diabetic, developed high cholesterol, and my thyroid numbers began fluctuating wildly. I attribute all this to LC because for over 20 years, I’ve eaten a Mediterranean diet. And I was an avid exerciser before LC made me too fatigued and weak to continue. I’m now on metformin, and pravastatin in my 40s, with a normal weight and healthy diet.
Rice and yams are indeed starches... but I am not an absolutist when it comes to lifestyle modification. I wouldn't tell anyone to stop eating any specific food - esp if they provide other benefits! - if there are other modifiable factors in your health ecosystem to help reduce blood sugar levels..
For example, you might want to eat yams every now and then and skip the bread, pasta, cereal, wine... or increase your cardio .. or get more daily steps in a day.. or boost muscle mass... health is about trade offs, not on/off switches :)