That is of course not true, type 2 diabetes is an disease of excess carbohydrates which your body cannot store anymore
This has just happened to me last November although I’m older and not as athletic as you. I’ve done a few differently over the last 3 months. 1. As much as is reasonably practical I walk for 30/40 mins after every meal. 2. I’ve stopped snacking and increased my protein intake. 3. Crucially I’ve stopped eating cakes & white bread when I’m not on the bike and also reduced my carb intake on days when I’m not riding. I also got a CGM to see for myself what is happening after I eat. The walking makes a massive difference. Getting news that you are prediabetic certainly concentrates the mind.
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No, it’s the opposite. High fat diet causes insulin resistance and an inability to store carbohydrate as glycogen. You can literally eat an all fruit and starch diet and never get diabetes.
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That’s just not true. Carbohydrates are reactive (non enzymatic glycation, an example of which is Hb1ac) so your body needs to store them quickly but its capacity to store carbohydrates is limited to around 400g, full is full but our do not like to waste energy so excess carbs are converted to fats for storage.
You seem like someone who is very on top of your health issues. Was this the first time you had your A1c tested? I’m going to guess yes. But you probably had your fasting glucose numbers as part of your regular physical so if those numbers have been normal, it seems odd your A1c is where it is.
I’ve been worried about my glucose too since I started taking a low dose statin (bad heart health in my family). More muscle helps with insulin sensitivity so perhaps try to gain some muscle – though based on your DEXA, you are already in the ideal range for bf% if I remember your age right. The other things I have read that might help are keeping most of your carbs around your training window (whether weights or cycling) and increasing fiber intake (I did this in part by switching almost entirely to whole grains, mostly swapping quinoa for rice, etc.). Apple cider vinegar before bed is also supposed to help, but I haven’t been able to stick with that due to the taste. For a while I tried taking a fiber supplement about 15 minutes before each meal but I stopped that b/c I was losing too much weight. But fiber before a meal is supposed to help with the glucose response, so you might try that.
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HFLC, sure … essentially ketogenic. Because in that context your blood sugar is needed by the brain and rbc. If the muscles started soaking it up at rest (due to insulin) you’re gonna have a bad time. A hallmark of this insulin-resistant state is it completely resolves after a couple days of very modest carb intake (100g for average daily activity – if you’re doing a bunch of exercise here it will take “more” to upregulate all the glucose handling machinery).
If you really just mean high-fat, I think what you’re actually implying is high-fat+high-carb (this is what all the literature means, anyway), which basically everyone agrees is the worst place to be (eg, donuts, potato chips/fries).
Citation needed. A ketogenic diet does lead to depleted liver glycogen, but muscle glycogen is not really impaired. Liver can still produce carbs via GNG to restore muscle glycogen after exercise. And GNG goes buck-wild during high intensity exercise. Muscle contractions activate glut4 so muscles can take in additional glucose without assistance of insulin.
Citation needed.
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I would monitor your numbers and do what your doctors say. Too many armchair docs in this topic…
I’ve had “pre-diabetic” glucose numbers for decades. I’m always slightly over 100, maybe 105. Every doctor since this was noticed in my 40s has said that they were not concerned one bit.
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You dont day where you got your numbers from or what units are used.
What ever you do, have this discussion with a trained/licensed medical practitioner.
All I will say is the numbers you have provided dont seem to add up compared to the information supplied by the UK diabetic association
best of luck
J
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Just found this thread. Responding as I read the post and as I ADHD-skim the rest.
What is your daily protein intake?
Also, I’m jealous of wherever you live (because mountains). And… I wonder if that has anything to do with elevated a1c… I’ve never looked into it. 8500 is high altitude living and I could see blood sugar running chronically a little higher (mostly because it’s a black box for me… this is a hunch).
I just Dr. GPT’d it:
This is normal and good.
This doubles the importance of my protein intake question. Yes, you could be undermuscled.
Recommendation:
- Consider increasing protein intake to 1g/lbs bodyweight. As you age you need more than normal, FYI, and I’m inferring that your username is accurate.
- Consider lifting weights. Start SO easy and light if you’ve not done this in a while. Progress to sets of 3-10 reps, with 3-6 exercises per day, 1-3 sets per movement, using loads that eventually put you a 2-5 reps from failure each set. Email me if you want a plan at steep discount (just comp’ing me for my time and website hosting costs) from what I used to sell them at. They’re no longer on the market only due to company-product mismatch. Still great lifting for cyclists/runners who care about progression and serious strength.
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Interesting. Does that imply it hasn’t changed in 10 yrs? That seems good? Higher genetic baseline but low lifestyle-related elevation? How meaningful is the trend in HbA1C over time vs a single point estimate? Are there clinical criteria for repeated measures?
@oldandfast interesting question. It seems like 99% of indicators & controllable risk factors you’re reporting are spot-on optimal, but one number happens to be high? 
(*edit: not even high, borderline-borderline-high)
Not a doctor, not a statistician, but if the arbitrary cut-off value for HbA1C between “normal” and “pre-diabetes” is population based, there’s gonna be a standard distribution of actual risk/probability of diabetes onset among all individuals at that arbitrary cut-off value. All the other associated factors seem important.
Change nothing and monitor is often a reasonable option. Hope everything works out for you!
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No. I have other 3 readings since 2009, from 5.2 to 5.5.
Yes, I have multiple of those readings and it was always from low 80’s to mid 90’s, now I’ve had multiple days around 100 in last 10 days, since I started measuring daily.
I use the units that we use in the US
Pretty good 165g average for last year. That’s like 2.5g/kg. I could go higher if needed.
Will inquire
I already do this
Thanks!.
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Yep. 5.3 - 5.5 range for 10 yrs. Generally stable, but does bounce around a little.
I do eat a lot of carbs. In part because I have high cholesterol, and as a result, avoid saturated fats.
Neither me or my doc are too concerned about it because it’s stable and I don’t have any negative symptoms (best I can tell).
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What’s your appB?. It turns out carbs also contribute to high cholesterol readings.
As a 55yr old male athlete who has done an Ironman, an Everest and regular 1-3hr road races in the past year and IMHO likes to think I have nailed my nutrition, some of those carb numbers look low to me and much of the conversation on the TR podcast would back this up.
For example on your 2-3hr hard rides, you are only doing 30g/hr. You have to remember that you are not just fueling for the ride, but your recovery as well.
My other observation is that you only go over 60g/hr in races. The current practice is to train your gut to absorb more carbs in a race situation.
The picture I am putting together is that your body is utilising energy from fat and muscle, because you are under fueling.
What you don’t address is how you are fueling before a ride.
If you have a device which tracks your caloies over the course of the day are you matching that number? If not them look up your basal metabolic rate and add on the calories consumed through exercise.
Probably the best person to help you answer this question is a qualified dietician with a sports background. I’ve been listening to Taryn from https://www.dietitianapproved.com/podcast for a few years and she dispenses a lot of sound practical ideas. Taryn’s a massive fan of wholefoods, eating 30 different natural foods each week and eating the rainbow. She has previously worked with the Australian Institute of Sport. The AIS site also has some useful info as well Nutrition | Australian Institute of Sport
I recall watching Ironman Youtuber Lachlan Earnshaw make a video last year about how he was also in the risk range of being pre-diabetic. Needless to say that his diet consisted of a lot of highly processed foods because it was easy and highly available. Remember that not all carbs are equal.
I look forward to hearing about your progress.
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At risk of kicking a hornet’s nest like the last time I wandered into one of these threads…I’ll briefly speak in generalities.
This figure shows the rate of development of type 2 diabetes (T2DM) based on BMI (x-axis) broken down by physical activity levels (different colored bars). This demonstrates that if you have a BMI <24, exercise eo ipso is not necessarily protective.
T2DM is a disease of insulin resistance, not hyperglycemia.
T2DM is more “heritable” than type 1 diabetes (T1DM), which often surprises people. You have a higher chance of developing T2DM if a parent has T2DM than you are to develop T1DM with a parent with T1DM.
Body composition should be interpreted as a Z-score, not as an absolute percentage. Older folks are supposed to carry more adipose. It’s healthy.
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When your blood glucose is high that is never the case as glucose is harmful (as it is reactive through non enzymatic glycation ) and your body will try to get rid of it ASAP, either by storing it in an inert form (glycogen), using it as preferred fuel, storing it as fat or excreting it (as honeysweet flow, the literal translation of diabetes melitus and how doctors in the past used to diagnose it: by tasting their patient’s urine)
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Yes, I’m pretty good on all this. So the under-muscled hypothesis is now discarded.
————— On the statins question:
I did a deeper dive in the statins, so it seems that Rosuvastatin is riskier (more potent) than Pravastatin.
However, here are looking at a “small” dosis that is 4x what I’m taking. The only study that I found with some relevant info regarding small dosis is of lower quality
For now I’m staying put, and see if the changes in diet make any significant difference. I have an appointment with one of the best lipid and metabolism experts in the country in a couple of months.
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100% agree with this. I’ll also add Lachlan was eating a LOT of fat, especially from processed vegetable oil, due to the processed foods he was consuming. He also ate very little fresh foods or fruits in general. He was basically the same Sam Sulek of triathlons, minus the drugs (probably).
nope, the fact that more old people do should not be accepted as the norm or healthy @oldandfast
T2DM is a disease of insulin resistance, not hyperglycemia.
nope, it’s a disease of full energy stores and hyperglycemia in itself is a bad thing and should be avoided
You have a higher chance of developing T2DM if a parent has T2DM than you are to develop T1DM with a parent with T1DM.
Energy store distribution might be heritable but of course dietary habits play a large role too
My reading of the tests is that I’m good even in an absolute basis. Of course I don’t compare myself with other old people for anything. I race with the youngsters when allowed.
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