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Old 03-20-2009, 12:38 PM   #1
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Pre-diabetic with A1C of 5.9

My doctor told me about a year ago that my fasting blood sugar was a little high. This surprised me because I am very, very active. I run and swim and bike. I am also thin, I am about 5'6, 100 pounds, 51 and female. I am very strong, very athletic, NOT a candidate. How can I be pre-diabetic? Last year, when she first told me fasting sugar was high I got an A1c. It was 5.8. Now, a year later with extra care, I just learned that it is 5.9. Diabetes is in my family, yes, but if anything, I have trouble being too low, not high. Sometimes I wake up in the night, dizzy, nauseated, feeling very bad. I will sweat what feels like ice water, I think I am going to die. Then, I have a juice or an orange, and I get better. My diabetic brother taught me to do this. Believe me, it is horrible to crash like that. I hate it, but it makes me wonder, how can my sugar be high if this happens? And how am I supposed to eat? How can I have the energy that I need to run? I am training for my 9th marathon. I need to eat! For example, if I eat right before a run, in my 3rd mile, maybe 15 minutes in, I will start to crash, clammy, cold, dizzy, disoriented. Sometimes it is very bad. I get through it, and I have learned to eat an hour before the run to avoid it. What does this mean? Will my blood sugar keep going up?

Last edited by ritahelen; 03-20-2009 at 01:24 PM. Reason: it wasn't finished

 
Old 03-20-2009, 05:21 PM   #2
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Re: Pre-diabetic with A1C of 5.9

Just because you take care of yourself doesn't mean your risk is 0%. If it's in your family sometimes you will get it even if you do everything you're supposed to be doing. Your age and the fact that you have a family history is just seemingly outweighing the fact that you are active and not overweight. The fact that you have it in your family and the fact that you're over 45 does make you a candidate, unfortunately.

Last edited by catheryn; 03-20-2009 at 05:21 PM.

 
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Old 03-20-2009, 06:56 PM   #3
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Re: Pre-diabetic with A1C of 5.9

My brother who is slim and athletic became an Insulin Dependant Diabetic at age 48. He has never smoked, rarely drinks, had a very clean diet..... Well that was 12 years ago...Our Grandmother had Diabetes...our parents did not.

I am on medication now for Insulin resistance. I am average, very athletic, clean diet, do not smoke....I started having trouble with my weight and knew something was up. I also had a change in my energy...... My blood sugars are great but my 2 hour PP Insulin was sky high so I am on Janumet in hopes of preventing diabetes....I feel great on it.

You had better get a 2 hour PP glucose and Insulin done and see what is going on with you.. How high is your fasting blood sugar? Hypoglycemia can be connected to Insulin resistance and pre diabetes. Make sure you are eating enough protien and frequent meals while training....

Make sure to take care of yourself........O

 
Old 03-20-2009, 10:33 PM   #4
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Re: Pre-diabetic with A1C of 5.9

Thank you for your response Catheryn. I suppose I am bothered by this more because I do not know what I can eat. Sometimes I eat, and I am horribly dizzy. I wish I knew what to eat during long runs, for example, so that I do not get that crashing sensation.

 
Old 03-20-2009, 10:36 PM   #5
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Re: Pre-diabetic with A1C of 5.9

Thank you O....my fasting blood sugar is usually around 110 or so. I check it in the morning. It is occasionally higher, up to 125, but that is rare. Once last month it was only 86. I can tell which days it will be high in the morning because I wake up a lot during the night. I need to learn how to eat so that I can continue my training. I am working on it. I am not familiar with the tests you mentioned. I will look into it. Thank you for your response to my post.

 
Old 03-21-2009, 03:36 AM   #6
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Re: Pre-diabetic with A1C of 5.9

Quote:
Originally Posted by ritahelen View Post
I suppose I am bothered by this more because I do not know what I can eat. Sometimes I eat, and I am horribly dizzy. I wish I knew what to eat during long runs, for example, so that I do not get that crashing sensation.
Long distance running and diabetes are a special challenge. It took me a while to figure out what works and what is optimal. I also do triathlons and running and swimming do completely different things to my body. It's so strange. Biking is more like running.

On weekends I usually go for a 20 to 30km run. I eat nuts 1 hour before and it will keep my glucose levels fine for hours. Or a roasted chicken leg 90 mins before, works well.

The fact you go hypo (low) 15 minutes into a run is interesting.

Did you try measuring just before the run ? If it's below 90, I will struggle through a 90 min run. I notice it by the pace I can keep. If it's above 140, in my case, I know there is a lot of insulin flowing around and if I run, within 20 mins it will kick in and cause my glucose level to drop like a rock.

These days if I go for a 10k run, I do it on an empty stomach. If I do a 20k or more I use the fatty food trick. Nuts/Peanut butter.....not KFC :-). The beauty of running is you can afford to take on the calories associated to the good fats.

If you are new to this, step 1 is to probably measure before your run and also to be figuring out what foods do what to your body. Trying to get a good starting glucose level, without the use of high GI goods (like orange juice) is my bet on how you will be able to best make it through long runs

Ignore the carb loading stuff normal runners talk about until you figure it all out.

There is another poster, DiabeticAthlete who has done some marathons as well, hopefully she reads this and gives her assessment. However you are probably very different than her or I. I think she is type 1. Getting to know your body is a long process.

Last edited by itotito; 03-21-2009 at 06:03 AM.

 
Old 03-21-2009, 01:46 PM   #7
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Re: Pre-diabetic with A1C of 5.9

I think your best bet, ritahelen, is to make sure you eat something before and after. What you eat it dependent on how long/intense your work out is. I was told to eat something like cheese and crackers or some toast before I work out. You might want to carry a small tube of dex tabs or other glucose tabs. when you feel dizzy eat a couple and you should feel better fairly fast. When you exercise your blood sugar goes low. Since you are pre diabetic it's important to eat like a diabetic would, and making sure you eat is as important as making sure you don't eat too much

 
Old 03-21-2009, 03:12 PM   #8
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Re: Pre-diabetic with A1C of 5.9

Thank you Itotito,
I just got back from a 20 mile run, I guess thats around a 32K. Thank you for your response, I am going to check my sugar now, just to see what it is, but when I just read your post, I was encouraged. I have found that I do better if I do not eat immediately before going out to run also, especially if it is just a 10K run or so. I actually do not feel like I HAVE to have anything for as much as a half marathon, but for some reason, I do feel like I need something during the run if I eat just before going out. Today I ate an hour and a half before running and I carried a Gu gel just in case and nuun water. I only ate the one gel, and to be honest, it made me nauseated. I know I need to eat something an hour or so in to the workout, but I do not know yet what that is. What used to help does not help anymore. When you go on your 20k or 30k runs, do you carry an energy gel? I stopped using Gatorade and Powerade last year when I first started having trouble, but on a long run, I need something. I think I would run more efficiently if I could solve this. I did okay today though. I had finished the Gu around 15 miles and I still had a good negative split, my last 2 miles being the fastest, even with the nausea. It was not that bad. I do feel ready for my next marathon. Thank you for your suggestions.

Last edited by ritahelen; 03-21-2009 at 03:13 PM. Reason: to address it to Itotito

 
Old 03-21-2009, 03:15 PM   #9
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Re: Pre-diabetic with A1C of 5.9

Thank you Catheryn, I am working on it. I will solve this. Actually, I think in the end, I am quite lucky. I am aware of what my body is doing and I enjoy the activity that helps me. I just need to sort out what to eat and when. On long runs, I need to sort out what will keep me going without making me feel like I am going through peaks and valleys. You are very kind to respond.

 
Old 03-21-2009, 05:52 PM   #10
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Re: Pre-diabetic with A1C of 5.9

Don't mention it, ritahelen, that's what we're all here for

 
Old 03-21-2009, 07:16 PM   #11
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itotito HB User
Re: Pre-diabetic with A1C of 5.9

Quote:
Originally Posted by ritahelen View Post
When you go on your 20k or 30k runs, do you carry an energy gel?
I only carry water. In the summer, because of the extra sweat, I make sure I take calcium/magnesium supplements every day or else I cramp up after an hour. Gatorade is great to replenish minerals but the carbs scare me. I have used it when cycling, but sip it very very slowly.

One thing you can try is a cup of boiled green lentils. They won't start raising your glucose for an hour and will slow keep it up for another hour. So they are nourishing you between hour 1 and hour 2.

You probably want to avoid anything that raises your glucose quickly, either very sugary or gaterade. This will cause a quick rise in glucose, an insulin hit and the excercise makes you go hypo.

Shelled peanuts are convenient because I can fill my pockets and eat them up until a few minutes before race time.

Last edited by itotito; 03-21-2009 at 07:28 PM.

 
Old 03-21-2009, 07:55 PM   #12
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Re: Pre-diabetic with A1C of 5.9

Thank you again Itotito. I think you make a lot of sense. I could never do the "carbo-load" thing anyway...it always made me feel awful. Makes no sense to start out feeling bloated, headachey and bad. I don't typically share with other runners that I don't want to eat any energy food during a run. There is that belief that out there that we absolutely must be eating something every hour or 45 minutes or whatever, or something terrible will happen. And then, being so skinny, I get a lot of dubious looks, like I am going to run off any second and purge. It's not like that. I don't want that horrible feeling of being too hungry. I want to feel strong and good the whole way. After learning this from you, I think my instincts are right. I am going to stick to my strategy of a healthy meal an hour before the run and carry water. I am going to try your suggestions. I like the idea of peanuts. I've carried them before, they work. I guess I need to be resigned to the fact that as I age, my body will be less efficient at processing the sugars and carbs I need to eat, so I may need to go on medication. Diabetes is big in my family. I was thinking I could outrun it...maybe not. But I may stave it off for a few years at least. In the meantime, I am going to keep running, biking and swimming. I love it and it is so good for me. I'm going to race a half next week and I expect to win my division! Thanks a bunch.

 
Old 03-22-2009, 04:48 AM   #13
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Re: Pre-diabetic with A1C of 5.9

I read an article that even non diabetics runners should not consume sugary/high carb food or they to could have the hypo reaction caused by insulin being too high.

I don't know if you know the mechanics of what is happening so apologize if I am stating the obvious. If you drink a glass of orange juice 15 minutes before a run, it will raise your glucose levels very fast. Your body will produce insulin to counter this rise. But many T2 diabetics are insulin resistant meaning the insulin has little effect so the pancreas creates more. There is an insulin buildup.

Excercise has this magic effect on the way insulin is used. So you have all this insulin flowing around and you start running, which triggers the insulin to be used and then you drop very quickly.

Let's say this doesn't occur in the first part of you run. But when you run for a long time, you are burning stored carbs and the glucose your liver can produce. The big question will be if your liver can produce enough. If not, you will go hypo. What you ate several hours before will make a big difference in how long before this runs out. Early morning you will run out sooner, since your liver probably got depleted over night.

So the ideal is to have a full liver reserve and some in your stomach ready to be slowly released. Lentils will release very slowly (maybe too slowly).

So your choices in that healthy meal will make all the difference on how long your glucose levels will stay up. You choices hours before the race will also make the differences in your liver reserves.

How fast do you do the 1/2 ? I was just over 90 minutes last fall.

 
Old 03-22-2009, 09:42 PM   #14
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Re: Pre-diabetic with A1C of 5.9

No, I did not know all this. Thank you. I know that being diabetic means not producing enough insulin for the sugar or carbs consumed to be metabolized. I did not understand the connection for the other side, going too low. My brother goes to low sometimes, but only if he has accidentally not had enough to eat to go along with his medicine. He runs too, his best half was today, 1:23.40, amazing! Anyway, I wonder why, when I go low at night, I get so much worse than when it happens in a run. I mean, when it happens in a run, it is awful, to be sure, but I know that if I can focus and keep moving, almost like it is an instinct or something, then in about....oh, maybe ten minutes?....I get out of it. It goes like this. The terrible feeling starts during the third mile, but I tell myself as I run, hold on, by the 4th mile, you'll be okay again. I try as hard as I can to stay focused. I can't tell that I've slowed down, I just know I have to keep moving. When I look at my splits after, they go something like 7:50, 7:45, 8:25 (during the bad time) then my 4th mile will be right back there, at 8:00 or so, and I continue to be fine for the rest of the run. I have done this, and then gone on to do five miles or so. Once, it happened to me at 15 miles...I just stopped, I sat down, drank my water, walked home and I was okay. But usually, my splits are not bad after I get out of the rubbery, drunk feeling. And it only happens if I eat something immediately before I go out. I had granola bar, it happened. I tried bread and butter, it happened. I feel more confident starting now, when I am just a little bit on the hungry side. Not like "low" just not full, you know what I mean? When the same sensation wakes me up at night, there is no end. I get worse and worse, I get some juice, then I get out of it. I know I am through it when I start to sweat what feels like ice water. I will even go black and come back again as I am getting out of it. I think it has happened to me at night because I would run after work...drink a gatorade or something too sweet, then go home and go to sleep pretty much within an hour or so after running. I stopped drinking the gatorade last year when my doctor told me my fasting sugar was too high. It seemed crazy to me at the time that she said that I could have high blood sugar because this kind of thing happened to me with some regularity. Then, coincidentally, I stopped having this happen to me so much at night and I noticed the thing that was different was no gatorade. Well, regardless of why it happens, I think I have learned the way to stay out of it. I will not eat anything sweet and quick before running, regardless of what they tell you in the ads for them, and I don't use any of those sugary drinks anymore at all.

Thanks for your explanation. Now I want to do some of my own research. Oh, my best half marathon is an 1:40.06, my best full marathon is 3:39.16. A BQ time for a marathon at my age is 4:05, so I was pretty pleased with 3:39. I would like to run faster than 1:40 next week. I did that time this past November, then the marathon last December. I think I can do better. At least I will eat better before the events!

Thanks again for all the information!

 
Old 03-23-2009, 06:59 AM   #15
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Re: Pre-diabetic with A1C of 5.9

Quote:
Originally Posted by ritahelen View Post
I know that being diabetic means not producing enough insulin for the sugar or carbs consumed to be metabolized.
For some people it's not producing enough insulin, for others it's not using the insulin properly, for others it's a 'defective' liver....there are 1001 reasons, but basically diabetes is bad glucose control.

Reading, research.... are very important. But measuring your glucose levels at different times of the day, under various conditions will be the key to figure out what is going on in your body.

By the behaviour you described, you may not actually have an insulin production issue, but rather an insulin usage problem. Maybe. If so, that's a lot easier to deal with by excercise and diet.

What is interesting in your case is you run a lot, which is probably keeping your levels down during that time. Yet your 1ac is on the high end. This means you may be pretty high post meals. You probably want to look at them. You may be able to get your 1ac down just by figuring this out.

Your high morning numbers may be the result of bouncing off a low during the night. Maybe.

Good luck, let us know how you do with the glucose levels and the 21k.

 
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