[AnnV]

I have been lurking for a while and reading posts. I also went to bloodsugar101 and read the information there, but I am still confused when it comes to borderline or pre vs full-blown diabetes. 6 months ago my A1c test was 6.0, my doctor said I don't have diabetes, but I'm right on the line and he told me to cut down on carbs, and I have been doing that and testing my bg and trying to keep it below 120. But after reading posts, I know that my A1c translates to 125 and that is above normal, so how can I not have diabetes, or at least be borderline or pre?

What is the difference between borderline and full-blown diabetes? Do I have to eat low carb the rest of my life so I don't become full-blown? If that is the case, then doesn't that mean that everyone who has been diagnosed pre or borderline actually does have full-blown diabetes? If so, why would the doctor tell us we are pre or borderline if we already do have full-blown? This is very confusing.

 

[AnnV]

My doctor said I am not pre-diabetic and not borderline, but he said I am close.

 

[Shanny]

I think it's confusing because there are too many pseudo experts making decisions about things they know nothing about. My contention is that diabetes is like pregnancy - you either are or you aren't. The doctors seem to be compelled to follow policies which have more to do with politics than they do with either healthcare or medicine, and now are apparently making an additional distinction between pre-diabetic & borderline - good grief! But that's neither here nor there.

Unless you're running normal BG, with fasting in the 70s and postprandials around 100, you prob'ly should be taking precautionary measures of reducing your carb intake on a permanent basis. And there are no guarantees that this will prevent any progression of the disorder, but it will reduce your risk of developing complications from it. Forewarned is forearmed, right?

 

[Patdart]

I fully agree with Shanny on this topic. My father had blood sugar higher than his doctor wanted it to be, but I never heard the word diabetic used by the doctor. He never was treated for it, but ate few carbs other than desserts, when I tested at 6.9 and began to read everything I could find on it, it seems I'm diabetic, but controlled by diet. I also asked a first cousin of mine about the family history and it seems we had a number including him and his son who ran high blood sugars. Anyway, I stay around 90-100 fasting, and I watch what really raises my sugar after eating. In a year of being very careful, I pretty well know what I can eat and what I can't...so I consider myself diabetic at this point.

 

[AnnV]

My contention is that diabetes is like pregnancy - you either are or you aren't.

That's what I was afraid of. So doctors are telling their patients they are pre or borderline, so they are going away thinking they can cut down on carbs for a while, then be cured. Or thinking they don't have to watch what they eat that closely because they don't have diabetes. It seems like diagnosing people with pre or borderline is making things a lot worse for people. It is bad enough being diagnosed as pre, then you have to go through that worry and stress all over again once your bg goes up and you are diagnosed as having full-blown. I don't understand why doctors do this, unless they also believe that borderline and pre-diabetes can be cured.

Since the number of diabetics is now so high in the U.S., if they counted in all of the pre and borderline, the number would probably amaze us.

 

[Shanny]

Exactly! But if you go to the ADA website & see the outrageous things they promote as fact, you'll be more confused than ever. They operate on donations & their biggest donors are big corporations. http://www.diabetes.org/donate/sponsor/our-corporate-supporters.html

American Diabetes Association Corporate Sponsors Big Pharma | HoldTheToast! by Dana Carpender

Docs are apparently bound to follow ADA guidelines, whether they believe it or not.

 

[smorgan]

Maybe it's true that you "are or you aren't" but that's not the same thing as saying we actually know how to determine which it is.

Is 6.0 just your body's "set point" where it DECIDES to keep your glucose or is it the beginning of your system being overwhelmed and will continue to get worse. Hard to say. Non-diabetics are not in some very narrowly defined range. Like all biological phenomena, any population will display a mean value and values distributed according to a standard deviation over a bell curve.

Please look at this graphic of a constant glucose monitoring trial of a healthy, non-diabetic population (their average A1C was 5.4):

CGM Trial

As you can see, normal people are not simply "in the low 70's fasting". Actually, the AVERAGE is 80 and within 2 standard deviations they range from 61 - 99. None of these people are diabetics.

Also note that A1C is notoriously inaccurate for a variety of reasons having nothing to do with actual blood sugar levels or the presence of absence of diabetes. One example is the average lifespan of your red blood cells. If they 'cycle' (die and are replaced) faster than average, your A1C will read lower, if they cycle slower it will read higher.

In reality there is no conversion from A1C to average BG the one you find is only based on an average for a sample population. That doesn't tell you where you are on that particular bell curve. If you really want average BG, test every 30 minutes for an entire typical day and take the average!

Having said all that, I'll say YES, you should test and monitor your BG carefully and another PROBABLY, eating low-carb for the rest of your life is no doubt an excellent idea and may just be necessary for good health.

 

[jwags]

I think doctors do a lousy job treating pre diabetes. I remember about 10 years before I was dx'd with D my fasting was 104. All my doctor said is watch your sugar. Well, I rarely ate sugar so I thought I was OK. Fast forward 10 years and I was dx'd full blown D with fasting of 240. So I should have been told to test so I could have prevented lots of damage. Now I watch all carbs, not just sugar and keep HbA1c around 5.3, which is still higher than normal. A normal HbA1c runs from 4.0-5.2 or so. So even at 6.0 you are well above normal, although not diabetic quite yet. You are in that risky zone. If you are over weight they may call it metabolic syndrome or glucose intolerant but it is all part of the same disease diabetes. Since you have been testing I would rotate testing some fastings, some after meal bgs just to keep abreast of if your disease starts to progress. A normal non D will usually be back to fasting after he eats. So use that as your cue to keep after meal bgs as close to 100 as possible.

 

[AnnV]

After reading all of your replies, I am even more confused than I was to begin with. I guess the question I should have asked in the first place is, does anyone know anybody who was pre or borderline, who ate low carb for a certain length of time, then could go back to eating whatever they wanted and were cured of pre or borderline? If the answer is no, it seems to me there is no other conclusion to reach than that pre and borderline are actually diabetes.

Sorry to be so dense, but if someone has actually been cured of it, I want to know how to do it so I can do the same.

 

[Shanny]

...anybody who was pre or borderline, who ate low carb for a certain length of time, then could go back to eating whatever they wanted and were cured of pre or borderline?

I firmly believe the answer is a resounding NO. Low-carbing is a preventive maintenance lifestyle, not a cure. There is no cure.

 

[smorgan]

What is the source for this statement:

"A normal HbA1c runs from 4.0-5.2 or so."

??

What was the definition of "normal" which yielded a population with those A1C figures?

 

[jwags]

Usually when your bgs begin to creep up above normal range, it means that your pancreas is not working efficiently. Eating low carb allows us to get near normal bgs but the minute we go back to old high carb ways our numbers creep up. I do think many Americans, me included were addicted to carbs. The best way to live a healthy life is to make changes of the way we eat for life. I would think most of us who practice low carb eat pretty well and we are fantastic cooks making all sorts of desserts, appetizers and snacks. I think I am a better cook now than before diabetes. Your old way of eating was an unhealthy way of eating and sadly you have done your body a favor by going low carb.