Yes folks, it’s time for Lizzy to have another hissy-fit. The subject today is the term “pre-diabetes” which in my estimation is like the term “being a little bit pregnant”!!!
This term is used by the medical establishment much to the detriment of many diabetics who interpret the term to be that they really aren’t diabetic, just close to it.
Along with the diagnosis they’re usually given the great advise to : “not eat anything white(what about cauliflower?), lose weight, and exercise”, and they won’t get full-blown diabetes. These are real “detailed” instructions, if they’re given at all.
This is wrong in so many ways. First, if your numbers have reached these levels you are for all intents and purposes diabetic, and perhaps have been so for quite a long time. Here’s a chart:
So if your A1C is 5.6 or less you’re not diabetic and if it’s 5.7 or more you are “pre” diabetic? And if your fasting number is less than 100 you aren’t but more than 100 you are “pre” diabetic? If after 2 hours of an Oral Glucose Tolerance Test (OGTT) your numbers are more than 140 you are, less than you are not? Come on, let’s get real! If your numbers have reached those levels you have a metabolic problem no matter what it’s called and if you don’t start acting as though you are truly diabetic in a short amount of time you will officially be!!!
I know, I know, years back having a diabetic diagnosis meant job discrimination and inability to obtain medical insurance or even life or other types of insurance. Things have changed (not nearly enough) regarding those issues. So why are they still promoting the wearing of blinders for people.
I’ve talked with literally thousands of people over the last 10+ years on this issue, and for the most part people never take this diagnosis as seriously as they should. I’ve seen them say such things as:
”I cut out all sugar and white stuff, only eat whole grains, I lost 30 pounds and exercise 3 times a week, why am I still pre-diabetic (or why was I diagnosed as diabetic now)?” or:
“My fasting number is under 100 and my A1C is 5.7, how can I be pre-diabetic?” or for the ones who actually test:
“My 2-hour after meal numbers are always under 180(!!!!) so how can I be pre-diabetic still?”
I’ll address these questions from the bottom up:
Often by the time a 2-hour number is reached it come way down from numbers 200+, that’s why we say test for your “peak” or highest number. Multiply these high numbers by 3 or even four or more times a day and there you have the answer. Also no non-diabetic would ever have a number of 180 no matter what they ate!
Often fasting numbers are the last to become higher. Way before it shows in the fasting numbers the meal numbers can be through the roof. Unless you test at these times you’d never know this. Many people only test fasting numbers and think they’re fine. High meal-time numbers can keep the A1C higher, every number counts to a certain extent.
Whole grains have as many carbs as white bleached grains. They have a little fiber and are better for you nutritionally, but the carbs are the same. Also, sugar is just a carb like any other carb. Losing weight (if you need to) can help cut down on insulin resistance, but it doesn’t “cure” diabetes, no matter what you’ve heard in the media, it’s just not true! I’ve even heard where some doctors tell people if they lose weight they won’t be diabetic anymore. 
Five times a week is better for glucose control than 3 times a week. It doesn’t have to be heavy exercise, even walking will work.
To truly control the numbers you must limit carbs and control the amount and timing. That’s the fact. Cutting out sugar and white stuff might help a little, but eating a plate of whole grain pasta and fruit for dessert will spike the numbers just as much as a piece of cake. The carbs must be controlled.
Now I must mention the fact that unless a doctor specialized in diabetes they might know little more than the average person about it. It’s the luck of the draw whether your PCP or General doctor is really all that knowledgeable about diabetes. Many of them even believe the media myths (just be the biggest loser!) and even statements from diabetes organizations such as the ADA (yes, they promote the myths as well sorry to say). And they know even less about diets! The average doctor receives only about 4 hours of nutritional study during their entire training unless they specialize. Many people don’t realize this and think their doctor knows all about nutrition and diets. I might also add that many of them “think” they know a lot more than they in fact do know! 
The only way to avoid a diagnosis of full diabetes is to live as though you already have one. That included testing, carb control, weight loss, exercise, and all of the other techniques that control the numbers. And you must maintain these controls for a lifetime.
Otherwise you’re just a ticking time-bomb. Now that’s the real truth. It’s also why I so object to the term “pre-diabetes”. I really think they should call it “early diabetes” and give people the real knowledge to control it. But then again that doesn’t make good headlines or sell snake oil books or programs or supplements or………..
You get the point.
End-rant (for now 
)
Lizzy
© EMO 5/12
Knowledge is Power
When I was diagnosed, close to 11 years ago, I was told “you are diabetic”, given a prescription for some medication, and told to wait for a nurse to come in and give me an insulin shot. When I picked up the prescription I was given a 10-page booklet telling me “All About How to Mange Diabetes”, and sent on my way. That was the extent of my “education”. 
Lizzy,
Hi. Just wanted to know what you thought. I am currently Diabetic, and have used meds off an on. I was on Metaglip (which I hear is now being sued) and really didnt like the effect on me. I am 36 years old and was diagnosed pre diabetic when I was 26. My weight had spiked to 280 lbs. and sugar levels were in the super high 200′s nearing the 300 mark. Got control of it for a couple of years and lost weight. I am now at 191lbs and recently found out that my blood sugar levels (since I hadnt checked for a year or two) are back at the high 200 mark.
Since then I have gone back on my diet, gym and testing my sugar levels constantly. I am now getting readings of 170 – 190. My questions is, will this go lower as time progresses or should I be taking oral meds to help me battle this problem? I really do not want to take meds since I know so how this will affect my liver in the long run.
Thanks,
James
James high numbers will effect your liver. in addition to the rest of your body, much more than most medications. Whether you need meds or not depends on your body and lifestyle choice. If you can eat a diet that you can stick to for life even if it involves few carbs or if not you could use the help of meds to expand your choices. The same applies to exercise and weight. You have to do things that you can continue for life or else your numbers will begin to climb again. You’ve seen that this is true. There is no cures for diabetes, only control. And the control must be consistant.
Read my link Getting Started for more information on controlling the numbers.
Lizzy
Hi Lizzy, Irene again…
I am so confused with my numbers. My A1C was 5.9 my doctor told me I was pre-diabetic and gave me Metformin 500 2x a day..I posted this before and asked you if I should be testing and you advised me to do so. I have been testing morning-noon-night. Some morning numbers are 101-114..post numbers between 88 -189..dinner ..pre78-133..post 95-133..bedtime between 85-149.. They seem to be like a yoyo don’t know if this is still called pre-diabetic. My doctor just gave me pills and said I’ll see you next month.
Irene
Irene what times are you testing regasding meals?
Metformin can take up to several months to become fully effective, and it also doesn’t really help with meal numbers, carb control and exercise help with that.
Did you read the whole “Getting Started” section? http://lizzysdlounge.com/2012/04/14/getting-started/
Medication alone won’t solve your problem, it’s medication, carb control, and exercise that work together for control.
Lizzy
Thanks Lizzy I will be reading getting started, lots to read but very informative my problem is carbs and it teaches me how to control it..I have this constant hunger and of course what do I want! well it’s pasta!…didn’t know about the carbs.
Thanks for this site I have someone who listens.
Irene
Irene,
Most people, myself included, found that once they reduced the carbs the cravings stopped, along with the constant hunger. Carbs fuel the cravings!!!!
Lizzy
I loved this! I still vasolate on denial so this all made perfect sense. I can compare it to being an alcoholic….I’ve heard people say “he used to be an alcoholic” but he quit drinking so he isn’t any more. No, he still is…but he has stopped feeding his body the drink that caused the symtoms. I’ve known several people who had quit for 5-10 years and then started again…and died drunk shortly after that. His body is different than a normal person who knows how to stop after a few (alcoholics can’t) All those years of not drinking, did not cure his alcoholism. If you are, you are. Stopping drinking doesn’t change that. I can see the same thing with DM. Even if you keep your sugars low, you are still a diabetic. And you’re right Lizzy…the medical system does a great disservice to folks who are where I am….they need to treat it like alcoholism…..”This will NOT go away. You need to learn to LIVE with it. If you don’t control your BG..you will die…slowly…after losing a foot, a leg, your eyes etc.” We have to eat to live (unlike drinking
)…..and some of us didn’t eat terrible…to earn it…but it is what it is. And acceptance to this fact, is the solution.
)
I hope I have finally reached this acceptance…..I’ve been angry about it, esp since I am thin and eat well…so didn’t “get this” from that, but rather inheritance. I feel ready to focus on the solution and not whine about the problem
I see you’re beginning to see the light!
I must state again that you don’t get diabetes by what you eat, many people eat diets full of junk but don’t have the genes to develop diabetes so they don’t get it. Many overweight people never get it, and many slim people do.
You don’t have to just “eat to live”, you can still enjoy many foods you just have to control the limits and discover other things you never thought of that you really like. No hair shirts are needed, it’s okay to enjoy food (most of us do). There’s no need to be a martyr here!
Lizzy
Lizzy,
) But it didn’t show up for her until she was started on prednisone (a couple years ago) She’s 90 now, so I just tell her to eat and enjoy her life….:o)
Am confused. They talk all the time about how the USA’s health care system is going to go backrupt if we don’t get this epidemic of DM under control. I have also read lots of places that the introduction of high fructose corn syrup, the high consumption of fast food etc correlated with the increase of this disease. For me….my blessed mother gave this challenge to me
Holly if you believe everything you read you’ll go crazy. When I’m 90 I’ll eat whatever I bloody choose too.
Lizzy
Hi Liz
I was recently diagnosed with prediabetes..my A1C was 5.9 I am on Metformin 500 2x a day. My friend tested me with her meter and before dinner my BGwas 78 and 2 hrs after it was 149, is this normal? Should I be testing my numbers?
Thanks
No Irene, it isn’t a normal rise and yes you should begin testing and carb control as well. Read these links:http://lizzysdlounge.com/2012/04/14/getting-started/
Lizzy
Thanks Lizzy, I will be testing my blood now. I like you always thought you either had it or you don’t, now they come up with this pre thing. I will be reading your getting started, there is more information there than my Doctor is giving me.
Thanks Irene
Try to read as much as you can of the newly diagnosed section Irene, there’s lots of good information there that you don’t hear from doctors.
Lizzy
Did they put you on medication without having you check your blood sugars???
Holly who are you talking to? It should be me, and doctors put people on meds all of the time without testing. They’re uninformed.
Lizzy
I wish I would have found your sire 2 years ago when my Dr. told me I was pre
diabetic. Now I’m diabetic. If I had more knowledge. I’m on a diet but don’t know being diabetic what should I try to stay to daily with carbs. and sugar? Also once a week I treat myself to a nonfat yogurt it has 165 cal. carbs 36 and sugar 30
Thanks
Brenda
Brenda read the links in “Getting Started” for info on numbers and what to eat.
Lizzy
found your site had a a1c of 6.4 followed diabetic diet went down to 5.3 lost weight 338 to 260-265 since january 7 2012 till now hard to stay on diet exercise every day 10 miles of bicycling have ups and downs with diet support is key. kept a log of what I eat and you do not realize what junk you really eat and how much got into the thought of pre diabetic and you are right no such thing .
thank ron
Hi Ron,
Ten miles a day is quite a ride! Good work, keep it up.
Lizzy
I agree with you 100% .My doc.didn’t even tell me I was “pre-D.” She wanted me to lose weight,so she sent me to a diet person.And this is who suggested for me to get a meter and test.Well I did as I was told.My nunbers are from 126 to 191,My fasting is above 100 also.This tells me I am full blown diabetic.All the doc.says is to lose weight and I will be O.K. Bull you know what!
Hi Gracie,
People, even doctors, saying that weight is the issue is another one of my “rant” subjects. I know plenty of people (myself included) who lost a great deal of weight and are still diabeic and have to work very hard to control the numbers.
It’s BS alright, not blood sugar either!
Lizzy
Lose weight as a cure???? Not hardly!!! All the diabetics in my family are teeny tiny. In fact my grandma (we called her “Tiny”)was about 4″11″ and weighed about 90 lbs soaking wet…..what was she supposed to lose???
My Doc missed my dx for a few years because……….”You don’t LOOK diabetic”. I have a NEW Doc now that I adore.
Heads up Medical Peeps, skinny DON”T mean healthy!!!!!!!
Susan it also happens that anyone who’s the least bit overweight is automatically diagnosed as a type-2. Then when they don’t respond to treatment they’re told they aren’t compliant! Overweight people also develop type-1 and they can be insulin resistant as well.
Lizzy
Lizzy,
I am so happy to have found your blog. I was just given the pre-d dx. I have actually had some symptoms and that is why my PCP wanted to run some testing. I am glad to have found out that my numbers are high and I need to act now, but like you have said here you are or you aren’t. Having worked in the medical field for 6 years it is amazing to me that this termanology is so readily and easily used. I am to see the PCP next week to discuss “options”. Thanks for the great information – I now feel very ready to have the discussion and tell her what I want to do. It is so important that people understand what is going on and be involved in their medical decisions.
Hi Jennifer, welcome aboard!
I’m glad you found me too. As you can see by the post this is one of my rant subjects. You’re doing the right thing in learning all that you can about it on your own. Sadly many people don’t bother and just go by whatever the doctor tells them, and as we both know that can be very incomplete and very often cause more harm than good.
Spread the word and tell others who might need information about this site too.
Lizzy
Two years ago I was having regular blood tests because of elevated liver enzymes. I usually got a call telling me the enzymes were up and return in two weeks for another blood test. This time the technician said, “you have diabetes, your prescription has been called into the pharmacy, Good-bye”. I was dumbfounded! The doctor didn’t call and talk to me. I was lucky to have a friend with diabetes who helped. When I asked the doctor about a meter, he said I didn’t need one since I was pre-diabetic. Metformin made be deathly ill and after 4 months, I stopped taking the medication and watched my diet for three months and the doctor said “Okay, you are not diabetic anymore.” Wait….What?
Last week I visited my Doc for persistent leg cramps and left his office with an insulin shot, samples of Onglyza, a prescription for Glyburide, a change of BP meds, an appointment with a Podiatrist, and daily appointments with my Doctor to check my blood glucose levels. Blood glucose 434 mg/dL, HbA1c 11.7. I now have a meter and check regularly – no pre-diabetes, just diabetes.
Hi Sue,
You had some very bad experiences that could have been avoided. You don’t go from “normal” to 11.7 in a few weeks!!!
My advise would be to strongly suggest finding a new doctor as soon as possible.
Lizzy
Actually my present Doc is new and seems to be more alert to problems and effects of meds then my past doctor.
There was about a 17 month gap between “not diabetic anymore” the diagnosis last week, so no monitoring, medications, etc. What kind of damage was done during that time?
Pre-diabetes, my Aunt Annie’s fanny!
Hi Sue,
It’s impossible to say what, if any, damage was done. The human body reverts to healing when given half a chance, so as long as you try to keep your numbers as normal as possible from this point on you will lessen your chances for any complications.
Just taking good care of yourself from now on goes a long way. I know people who have had high numbers for a decade or more and have very little effects from it because they got in control and now have great numbers.
Lizzy
Hey Lizzy,
Another good post…. I will in a couple of weeks have my older brother here for a few days. I plan to test his A1c at that time, and I suspect he will have a problem. He has been avoiding this for a couple of years and I want to get the issue on the table and make him deal with it. I won’t let him go down the “Pre” road.
Thanks,
Rick
Hey Rick,
I heard what you said about me on the boards when you found out my hard drive died, you’re in BIG trouble when I get back on LOL.:-)
Just don’t turn into the diabetic food police with your brother, you know that might turn him off. I know you’re only trying to help, make sure you tell him that too.
Hope he does well with the news.
Lizzy
Hi Lizzy! I totototally agree! Over a year ago I was told I have a fatty liver, slightly enlarged. For years I’ve been taking simvastatin trilipix and hctz for really high trig and chol. They just kept adding drugs. To the liver situation i was told notto worry, just loose weight and get some exercise. Then Dec2011 my blood work was fasting146. Which she sayss put me over to diabetic. Had me get an a1c which was 6.4. I was told to try diet andexercise and retest in three months. No other education. I believe I was coasting under the radar for years. No one ever told me the danger! I have learned every thing from these boards and their referenced sites. I have lowered my a1c to 5.8 and am now testing and retesting to get it even lower. In looking at previous blood work reports i see it has been high for years. I wish i had known!
Hi Lisa,
I know, I’ve even been told that doctors didn’t even mention to people when their numbers were in the “pre-diabetic” range, just waited until it was full blown. Looks like that’s what happened to you.
I’m glad that you continued the search until you found “real” help, it’s just a shame that more people don’t. Many of them still feel that the doctor knows everything and just do as told. Bad mistake, your health is up to you, now more so than ever.
You did a good job with the A1C, keep up the good work.
Lizzy
Yup, thats exactly what happened to me. Just eat better… UGH!! I am so angry for that lousey advice which has allowed me to be careless so much longer than I could have been. Even now, the group health company I get to buy medical care from is lousey in their approach to teaching diabetics how to eat, live, and control BS. You have finally given me the intelligence to get it, and I am ever grateful.
Hi Michelle,
I hear this so often that I decided to write the post, from my frustration too!
Someone posted one time that insurance companies don’t cover prevention because they think people change insurance so much that any future problems won’t be their problem. I guess they don’t consider the fact that some of the “future” people will switch to THEIR company!
Lizzy
Hi Lizzy,
You know me from the ADA Boards as deafmack. I totally agree with you. You just keep ranting about it. Maybe one day the medical establishment will wake up.
Hi Kzthy,
I sure hope it’s sooner than later. Good to hear from you.
Lizzy
I wish I had been given this information 4 years ago. All I was told was lose some weight and try to eat a better diet. Anyone in my situation should be referred for diabetes education. I would have. Even given the knowledge and tools to control my BG so much sooner and better.
Until they start treating this as diabetes and stop the BS (I don’t mean blood sugar) people will continue to be mislead. They stick to the line “you can avoid or delay the onset……” Very few studies have been done on this, and most of the results are short-term only. The results of these few studies indicate that very very few people “avoid or delay” it at all, and still they persist on spreading this “party line”!
Oh Lordy, nice to know that someone besides me pulls their hair out when we hear this “pre-d” diagnosis. Hubby just got that song and dance from his PCP with an A1c of 5.8. I have to say that hubby IS making some small changes in diet and routine, but that “pre” dx lets him live in his denial bubble a while longer. Arrrrgggg!
Thanks for letting me rant!
Susan D
It makes me crazy Susan! You hear it all of the time from so-called “respected agencies” as well as from people trying to sell you the “cure”. And don’t get me started on those TV “doctors” and that biggest loser show!!!!
Hope your husband soon stops swimming in that Egyptian river and REALLY starts taking control.
Lizzy
Lizzy you can rant all you want about the term “Pre-diabetes”. I happen to agree with you.
Hey James, Howareya?
I always like it when people agree.
Lizzy
Well Lizzy you know me a jpg391 on the ADA community boards. I was told 30 years ago by a nurse that worked in a hospital that I was spending some time in when I was first diagnosed that there is no such thing as “borderline diabetes”, that is what it was called back then. She also used the words “its like being a little bit pregnant, ether you are or you are not, no in between”
Hi James, I knew it was you.
That was a rare person, someone who actually told you the truth! They usually just give you the old “agency lines” and drop it at that.
Lizzy