Pre-diabetes/glucose monitoring

[7costanza]

I just found out I’m prediabetic again, after working hard to reverse it in 2021. The first time I attributed it to pandemic stress, I don’t have that excuse this time as I’m significantly less stressed out these days. I’m at the high end of the healthy weight range, and I know the drill with changing my diet and adding more exercise, but am considering also monitoring my glucose and am wondering if anyone else has done that (either for pre-diabetes, gestational or T1/T2)? Was it worth it and any tips?

[Patsy Baloney]

I monitored during my first pregnancy because my first glucose test was a fail and my doctor preferred that I move to monitoring instead of doing a second test. It did not find anything abnormal, but what I thought was interesting about it was that it revealed to me food/situations (especially late dinners) that did funky things to my numbers.

I don’t know if that’s the type of info you’re looking for by monitoring.

[icedcoffee]

I monitored during my second pregnancy and found it immensely helpful and made me make lifelong changes like always pairing sugar with protein, walking after high sugar/carb meals. I took my levels 1st thing in the morning and then an hour after every meal. It's a pain in the fingers, but it is very valuable I think.

[megamous]

I am a type 2 diabetic and have to monitor my glucose. I have a freestyle libre 3 that continuously monitors my glucose. My insurance does not cover this particular level of freestyle libre, (they did cover the freestyle libre 1) so I can tell you the out-of-pocket price. It is $75 for two monitors that last two weeks each. I think you have to have a prescription, so if you can afford $75 a month, it may be worth asking your doctor for a prescription to see how foods and exercise are affecting your numbers.

[7costanza]

Mar 21, 2024 12:18:36 GMT -5 megamous said:

I am a type 2 diabetic and have to monitor my glucose. I have a freestyle libre 3 that continuously monitors my glucose. My insurance does not cover this particular level of freestyle libre, (they did cover the freestyle libre 1) so I can tell you the out-of-pocket price. It is $75 for two monitors that last two weeks each. I think you have to have a prescription, so if you can afford $75 a month, it may be worth asking your doctor for a prescription to see how foods and exercise are affecting your numbers.

I looked at those briefly last night, having the pricing is helpful, thank you! I may see if my doctor will write me a prescription.

[Susie]

I was pre-diabetic in 2021 too, after being dx'ed with GD in my 2015 pregnancy, but not in my 2019 pregnancy.  With benefit of hindsight, I have suggested to my PCP that I am not sure I truly had GD, I think I just struggle to manage glucose when I'm under major stress and my cortisol levels are really high.  I think he thinks I'm nuts, but.

2015 and 2021 were both times of outrageous stress in my life.  In 2015, my mom was dying of ovarian cancer but also simultaneously initiating drama about my brother's wedding.  I was a bridesmaid in that wedding at 8 months pg, the bride insisted I wear a non-maternity style, etc. etc.  Work was exploding, and I was billing at a rate way way way beyond anything I'd ever done before (and I was pretty seasoned by then).  Plus, you know, pregnant for the first time.  

I stopped the GD monitoring and diet when I delivered.  I had my A1C checked every few months afterward, and it hovered for a while at a very borderline level.  It did not resolve right away after delivery.  In that time I returned to work at 8 weeks as a FTM, EBF'ed/pumped, my own mom died, you get the idea.  

Eventually life stabilized, and so did my blood sugar.  I had A1Cs in the low/mid 5's, and I passed my 1 hour test with flying colors in my 2019 pregnancy.  Excellent numbers, no notes.

In 2021, I was a year into covid, a lot of which I spent parenting all day and working all night, with no regular sleep schedule.  I had stress-related insomnia when I laid down.  It was the worst and unhealthiest I'd felt since my 2015 baby was a newborn.  (It actually felt a lot like that.)  We sold a house (which I'd never done before), bought a new one in a crazy market, the same week I landed a huge new client, and then we moved.  Our kids still weren't vaxxed, and our lives were in constant chaos.  Childcare was unsteady.  Work drama was back to unprecedented levels.  And oh look, there goes my A1C into the 6's+...

So for me... when I have an A1C trending up, I don't go straight to the monitoring because ugh, voluntarily going back to the days of bruised fingers is not for me, and idk how much it would really help.  But it is a wakeup call to think critically about:  am I sleeping enough?  let's look at Garmin Connect at my workout schedule, is it often enough?  how are my stress levels?  how much am I working?  My billable hours at work give me a very close reading on this, actually.  Addressing these questions honestly generally solves the problem for me without monitoring, meds, or even major diet change.  I'm sure it's not the same for others whose A1C is driven by different factors, but this has been my experience.

[rhian]

I'll dissent and say that I don't think I would recommend monitoring yourself without oversight from a healthcare provider. I monitored during my first pregnancy due to gestational diabetes (4x a day, first thing in the morning and 2 hours after every meal), and I found getting high or borderline high numbers sooo stressful and made me super anxious, especially when I felt like I couldn't figure out why they were happening. I'm not a generally anxious person, so it was really challenging for me. There are so many things that can affect your blood sugar - stress, sleep, hydration, exercise, hormones, sickness, etc - so the data points were only somewhat helpful for me. I know it was necessary because I was diabetic at the time, but I personally would not do it outside of a specific recommendation from a medical provider, who can then also help you interpret the numbers and patterns. I still have the glucose monitor, but I have not tested my blood sugar myself a single time since giving birth over 2 years ago.

What I found more helpful were the tips for keeping blood sugar stable (eat protein with carbs, walking after meals, eating a regular ~3 hour intervals, getting enough sleep) and just more awareness of the range of foods that have/don't have carbs (things that were surprising to me: Bananas have so many carbs! Milk also has a decent amount. Berries don't have that many!)

[mcsangel2]

I recommend the supplement Berberine. I’m prediabetic too, this is considered a natural metformin without the side effects. It also has other benefits, that I wasn’t aware of, and it’s been incredibly helpful with my chronic pelvic pain due to menopause.

[atarianna]

My daughter is type 1, so different but I have a lot of experience with glucose monitors. CGMs are amazing. We have had the dexcom G6 and G7 and the Libre 2 and 3. The 2 requires scanning to see you numbers but the others are automatic; all give you numbers on your cell which is great. I think it’s great for people to periodically monitor BG because it really helps give you insight into what foods are better and worse for you and helps you make more informed decisions when eating. I kind of think of it like calories being present on menus while eating out; you KNOW something is not great for you but seeing that number is like “oh wow, it’s really really bad!”. Our entire family’s relationship with carbs and food has changed completely since my DD was diagnosed.

[7costanza]

Thank you all! There are some good points to consider here, I’m going to check with my doctor to see what she recommends. I think I would do better with a continuous monitor but not sure she will approve at this stage, but I’m very curious to know more about how what I’m eating impacts blood sugar.

[pinkpeony08]

My husband is just below pre diabetic. He did just a month of continuous monitoring (used goodrx) to see how different foods impacted his sugar. He found, for example, that rice spikes his blood sugar even eating with protein. And after eating something like fried rice with his dinner keeps his blood sugar elevated the entire night.

[coffee]

Mar 21, 2024 12:54:12 GMT -5 7costanza said:

Mar 21, 2024 12:18:36 GMT -5 megamous said:

I am a type 2 diabetic and have to monitor my glucose. I have a freestyle libre 3 that continuously monitors my glucose. My insurance does not cover this particular level of freestyle libre, (they did cover the freestyle libre 1) so I can tell you the out-of-pocket price. It is $75 for two monitors that last two weeks each. I think you have to have a prescription, so if you can afford $75 a month, it may be worth asking your doctor for a prescription to see how foods and exercise are affecting your numbers.

I looked at those briefly last night, having the pricing is helpful, thank you! I may see if my doctor will write me a prescription.

I was was just diagnosed pre-diabetic. My hemoglobin was 5.7 (5.7 is what you need to be diagnosed as pre-diabetic). I asked my doctor if she could prescribe me the monitor. She told me that since I was in the lower range, she is NOT putting it in my records, that way it doesn’t “make noise” ( for insurances and other matters or my deductibles would be higher). She said to prescribe it she would need to “label me” and as for now she prefers to keep it off the chart, hoping I’ll take care of myself and reverse it.
I appreciated that she I didn’t think about it. Then just got a regular old-fashion blood monitor.

[followyourarrow]

I'm T2 after being pre-diabetic for several years. Having a CGM has definitely helped me so much. I can really see how what I eat affects me. All fruit is a a no for me. An apple will send me over 200. I can get by with a little rice, or potatoes, as long as it's paired with protein. Plain white bread doesn't work, but if it's a true whole grain, a little is fine. I can have 1 cookie, just 1, 2 and it will send my sugar really high. Learning what works for me makes me feel like I have control again.

[holly116]

Mar 21, 2024 13:29:14 GMT -5 mcsangel2 said:

I recommend the supplement Berberine. I’m prediabetic too, this is considered a natural metformin without the side effects. It also has other benefits, that I wasn’t aware of, and it’s been incredibly helpful with my chronic pelvic pain due to menopause.

I'm working with a functional medicine dr. and she just put me on Berberine.  A week in, I can tell it's affecting my appetite, it's really diminished.  I'm also focusing on getting enough protein, front loading the morning: 45 gms at breakfast, 30 at lunch, and 30 at dinner.  

I have had some hormonal/gut related stuff that's jumbled a lot of my numbers.  My dr. focused on my gut to start, then overall inflammation, now we're focusing on cholesterol/blood sugar/estrogen.  There's SO much information out there, it has been well worth it for me to work with a functional medicine dr. to tell me exactly what to take, from which company, when, and in what order.  My regular MD was no help at all.  

For what it's worth, most of the supplements I'm on are from Ortho Molecular Products and I get them through Fullscript.  The berberine is in CM Core: orthomolecularproducts.com/product/cm-core 

It's double the price on amazon, I'm not sure if you need a dr. script for Fullscript, but it might be worth finding one if you decide to go the supplement route.

[7costanza]

Thank you all again so much! I messaged my PCP today and she prescribed the freestyle Libre 3, I picked it up today and am going to apply it tomorrow morning (wanted to hang out in the hot tub tonight and not worry I was destroying the adhesive on day one.) I’m a little nervous but excited to see actual data and be able to make changes based on it. The pharmacist spent like 10 minutes telling me how great it is, lol.

Another question, the app doesn’t seem to have a good method to track food and exercise, other than making a note and the ability to add number of carbs. How did you all reconcile or document food and corresponding glucose levels?

[cuadrado]

I would not use a CGM for prediabetes unless you’re working with someone who can help you interpret and understand the readings (like a Certified Diabetes Care and Education Specialist). A lot of factors go in to how your body responds to certain foods, and what happens a lot with these CGMs is that people get a high reading and only attribute it to a specific food.

Also a large majority of people with prediabetes don’t go on to develop diabetes.