How to Get Rid of Prediabetes?
March 13, 2013 6:53 AM   Subscribe

I just got blood test results back that reveal that I'm at the lower end of the range for prediabetes. My doctor wants me to go hardcore in the next three months, which is when she'll test me again. I'm just not sure how to do that.

About me: I'm a mid-twenties female. I am short, and very overweight. I actually do not know my exact weight-- I went on several diets when I was younger, and got so hung up on numbers that it caused me great anxiety and I had to stop. I've been trying to make peace with my body, and I've found that telling doctors not to tell me my weight when they weigh me helps.

I had been making steps towards eating healthier and generally living a healthy life. I had had middling success at this. I joined a gym, but so far I haven't been able to go more than once a week. I am working on this. Also, I will admit that, at least over the past few months, I have been going a little overboard with the sugary foods-- donuts, candy at the office, etc. Again, looking to cut that out. I also think I should mention that diabetes runs in my family, which has probably heightened my doctor's cause for concern.

I went in for my physical last week, and got the results back today. In past years, I've been healthy. My blood sugar has always been fine up until this point. My doctor told me that my A1C was 5.7, which is the lower rate for prediabetes. In addition to that, my vitamin D and B12 levels were low. My doctor advised me to take supplements for those. She also told me that my thyroid was a little sluggish, but also pointed out that it could be a lab variant due to a virus or whatever, and so I'm getting retested for that in two weeks. I have seen online that low B12 could affect both the A1C and the thyroid, but my doctor doesn't think that's the case. I haven't had thyroid issues before.

When she first left these results on my voicemail, she initially said-- more or less a direct quote-- to cut out sweets and work out more, and I would be tested again in three months. I literally thought that if I just ate less cakes and cookies and shit, and worked out more, I would be fine. But I had a question re: artificial sweeteners, so I called her for questions. She basically told me not to do that (I see why now after looking online). I like to drink fruit juice, so I asked about that, and she said not to drink that, although a glass or two a week wouldn't hurt me. She said that she mainly tells her patients to just drink water. (I will also admit that I really love Diet Pepsi, but wouldn't mind cutting it out entirely, or even having it once in a while, since I also love sparkling water. ) She says she wants me to be really hardcore for the next three months, because we're at a vantage point, or something like that. But my takeaway from that phone call was that I basically could not have sugar ever again, or at least for the next three months, and I would be doomed to water, and nothing but, forever.

I got very anxious about this. I am not used to change (working on this too). I spoke to my therapist, and we talked a little bit about what my doctor said. I came to the realization that it maybe wasn't specific enough, and that I could use another opinion as to what I should do. My insurance won't cover a dietitian/nutritionist unless there's an actual diabetes diagnosis, and I can't afford to pay for one out of pocket, so I'm looking to the internet for advice.

I'm wondering if there's anything else I should avoid food-wise, or anything else I should do. Some particulars:
-Are all fruit juices really that evil? Is there anything specific I should look for?
-What about breads or other carbs? During the workweek, I usually I have either oatmeal or an English muffin or toast for breakfast. For lunch I have a sandwich with meat and mayo and some yogurt. Do I really need to make many changes?
-What breads are okay? I used to like wheat, but I read somewhere that it's not much better than white.
-Do I really need to be that hardcore?
-Is Truvia okay?

-How do I not be so scared?
-How do I not hate myself? I feel like I caused this somehow. I'm not sure if this is some inner, fat-shaming part of me, or if my doctor is kind of making me feel that way, or what. I could be a bit more specific with what I'm eating, but now I'm ashamed to.
-Will I be all right?

Any book suggestions would be okay, as well. I'm a very weepy, anxious type of person who is currently premenstrual, so I am crying over this right now. I'd like any advice that would help. Thank you.
posted by anonymous to Health & Fitness (36 answers total) 31 users marked this as a favorite
Are all fruit juices really that evil? Is there anything specific I should look for?

Yes. Imagine all the fiber of fruit vacuumed out, all the cell walls pureed and destroyed, so that now your body gets all the sugar of fruit without having to work out the digestion. Fruit juice hits your blood stream like a candy bar, and the fact that people think it's "healthy" to drink juice (and give it to their children!) is a distressing manifestation of how divorced we are from good eating. Treat fruit juice like any other sort of sugary beverage.

My father is diabetic and he comes from a long line of diabetics. His father was given the standard 1980-1990s regimen of lower fat foods, and the man died of diabetic complications at 56. My father's doctor gave him a different approach:

Today, you begin a life with very very little bread. And very little pasta, rice, and crackers. Today you stop eating cookies, and for God's sakes please put down the donut and the cake and basically anything that comes in a shiny brightly colored bag that you can buy at the pharmacy or gas station.

Eat nuts, eat lean meats, eat all the vegetables (besides potatoes) that you want. Eat plain yogurt with berries. Eggs are good for you. Get used to Truvia, Splenda, erithryitol if you simply must have something sweet. AVOID all the crappy "sugar-free" candies that use sugar alcohols, as stuff like Maltitol has about the same glycemic impact as table sugar.

My father is 57 and his life has changed dramatically since he stopped eating low fat and snacking on munchie-inducing processed foods. He complained in the beginning, but after 4 or 5 days of the new diet, he couldn't argue with how much more energy he had, how he wasn't ruled by his appetite, how now when he saw donuts he grimaced at how even the smell was too sickly sweet.

He says that diabetes changed his life for the better, because he didn't know how poorly his diet had affected his life until a medical condition forced him to change his entire lifestyle so that he didn't die early like his own father. He's really, really happy now.
posted by zoomorphic at 7:14 AM on March 13, 2013 [36 favorites]

The thing about being pre-diabetic is similar to being pre-alchoholic. Once you're labeled as 'full-blown' it tends to stick with you. Not the condition, but the stigma. Like it or not, there's a stigma attached to type-II diabetes in young adults.

But there's good news! You're pre-diabetic, so you can deal with this.

It's really not that hard though. It's just a matter of 'do you really want to make a difference or not'. I'm assuming you do. So.... You don't have to be so hard-core it makes you miserable, but there ARE some things you have to accept and just 'do'.

Do go for a 20 minute walk every day. Every day. You can actually do this. No excuses.
Do go research foods that are low on the glycemic index.
Do plan your meals out to utilize low glycemic foods. You CAN actually do this as well. It's honestly not that hard. No excuses.
Do eat your cake one day a week.
Do believe that you'll be alright.
Do understand that it's OK to be a little scared - but don't take the drama route and let it overwhelm you.
Do take responsibility for yourself and your own actions. DO realize that YOU are in control.
DO NOT hate yourself. You're wonderful. You didn't 'cause' this, it just happens - to a large extent to all of us at some point or another.
posted by matty at 7:15 AM on March 13, 2013 [7 favorites]

Make SMALL adjustments. Give up a roll or a slice of bread here or there. Eat less starchy vegetables. Stevia is an all natural sweetener. Make some lemonade with real lemon juice and stevia. A1C of 5.7 is not all that high really. The dr is suggesting these changes to hopefully avoid first round medications. But even if you go that route eventually, all is not hopeless. I was basically in the same situation three years ago, took medication, made a few lifestyle adjustments, and I'm now able to back off the medication because of normal test results.
posted by tamitang at 7:16 AM on March 13, 2013 [1 favorite]

The best way to do this is to go low carb. I'm overweight with low/stabile blood sugar.

Focus on eating veggies, low-carb fruits (Cantaloupe, berries) and lean meats. If you're not allergic to nuts, eat them in moderation.

Fruit juice is nothing but sugar, it's no better than kool-aid for nutrition.

Artificial sweeteners can be problematic, many of them have chemicals that are terrible for you. Stevia is a naturally sweet plant, but some stevia sweeteners are mixed with other not so great sweeteners like Maltodexterin. Truvia is one.

I buy either SweetLeaf, or Stevita. I put them in coffee and iced tea.

I've given up soda for the most part, although there are some stevia sweetened sodas that I drink occassionally as a treat.

My Dad is a diabetic so I try to stay on top of this as well. So far, I've been doing pretty well.

I recommend Atkins For a New You. It has recipes.

The sad fact of the matter is you just can't eat crap. I'm 50, and I sure wish I had gotten a handle on this when I was younger.

You will withdraw from sugar and carbs, it will not be fun, but you can do it!

Also, make time for the gym! I walk on the treadmill for 30 minutes a day. I firmly believe that I am a fit fat person because I exercise regularly.

You are worth doing this for. It is worth eating well for your body and for your spirit.

Veggies and meat are your friends!
posted by Ruthless Bunny at 7:17 AM on March 13, 2013 [4 favorites]

When my dad had this (note: he is back in normal range), he basically started doing a protein and veggie diet, cutting out most carbs and sugar at his doctor's recommendation.

He was really strict about it for about 6 months. No starchy foods, no high-carb foods, no sweeteners, no foods naturally high in sugar. It's fairly similar to an Atkins or Paleo diet, though not to that extreme.

Are all fruit juices really that evil?
Fruit juices are naturally high in sugar. So in terms of what your doctor is telling you, yes, they're evil. If you must have juice, can you make your own and make it veggie-heavy with some of the "better" fruit -- low-carb fruit list.

What about breads or other carbs?
Don't eat them. Try juicing for breakfast (or eggs -- I usually alternate), and substitute a salad for the bread at lunch.

What breads are okay?
Until your doctor says otherwise, none. They are all high in carbs. It looks like your doctor didn't actually mention this, but perhaps she didn't actually discuss what your current diet is like? Anyhow, it won't help you. You can start eating bread again when you aren't pre-diabetic.

Do I really need to be that hardcore?
Yes. My dad was really hardcore for about 6 months, and it brought him completely into normal range.

How do I not hate myself? I feel like I caused this somehow.
By knowing that you can do something about it. Lots of people have health problems -- you are seeking help, and that's admirable. It's really easy for people to have health problems because of the amount of crap food that is cheap and easy and shoved in our faces. It's very common. You're not in some outlying group of terrible people. Yes, you did it to yourself -- but you had a lot of help, including things like genetics that you have NO control over. So you can un-do it to yourself as well, IN SPITE OF the factors that are pushing back.

Any book suggestions would be okay
You don't mention what you're doing for exercise, but I'll suggest this: Body By You. It's the first do-it-at-home program that I've had success with. It's all bodyweight exercises, it's a clear and simple program, and it is designed to figure out your current fitness level and take you up gradiently, but effectively. I'm 2 months in, and it's been really easy to stick with, and I can see the progress (yay!). There's also a Fitocracy group, which I find really helpful for motivation and support.
posted by DoubleLune at 7:18 AM on March 13, 2013 [3 favorites]

It's a very scary thing to hear, so you have my sympathies. But hang in there. This doesn't have to be drastic. Yes, you should avoid obvious bad things like fruit juice. It metabolizes quickly and doesn't have the required fiber to slow down the conversion to sugar. Fruit itself still has that fiber, so have an apple instead of apple juice. In general, keep foods closer to their original form and you'll get more benefit from them. Eat more veggies, less bread. Especially white bread. Eat whole grains. Skip the candy, pastries, etc. Breakfast is the hardest to change, mentally, if you're used to toast or bagels or English muffins. Have eggs for breakfast with some cheese and veggies in. Yogurt is ok, but don't get the super sweet kind.

More importantly, though, get outside and walk every day. If it's raining, walk anyway. If it's snowing, go to a mall and walk inside. Get an app on your phone that keeps track of how far you're walking (I like RunKeeper, but there are a lot of them). Try to increase your distance and speed a little every week. Maybe eventually you'll start using your gym membership, but taking a walk outside is more fun, especially as you start to get more fit.

I've had full blown diabetes for 12 years, at my worst a couple of years ago with an A1C of around 10, and now am normally around 5.1. I lost 75 pounds. And I did it by walking and tracking my food in LoseIt.
posted by clone boulevard at 7:18 AM on March 13, 2013 [2 favorites]

If you want specific eating plans and suggestions, take a look at The Instinct Diet. Ignore the "diet" part in the title, and read the book for the science it presents on its eating suggestions, which are largely based on research on pre diabetic and diabetic people.
posted by needled at 7:19 AM on March 13, 2013 [1 favorite]

When a family member was diagnosed as pre-diabetic, he attended diabetes classes for about a month to help him adjust to it and learn what to do. Talk to your doctor to see about something like that in your area.

He was able to reverse his pre-diabetes with a no-to-low carb diet, cutting out all sugars, portion control and exercise.

Wishing you luck.
posted by girlmightlive at 7:22 AM on March 13, 2013 [2 favorites]

Nthing going the low-carb route, but another small thing to consider is cinnamon supplements, or just usins cinnamon generously in your tea or as a spice for foods if you like cinnamon.

A lot of research has shown that cinnamon helps control blood sugar levels. Maybe someone can provide a reference, but I've heard it from many sources over the past couple of years. (Of course, if you eat a big cinnamon roll, that is bad, but if you sprinkle it on low-sugar yogurt or take a supplement, it could have a positive effect in addition to exercising and cutting out sugar/carbs.)
posted by shortyJBot at 7:27 AM on March 13, 2013 [1 favorite]

It's just three months. You have basic instructions for what you need to do. This doesn't need to be a time of sorrow and despair.

1. Pick a low-carb eating plan. Atkins, South Beach, Slow Carb/4-hour Body, Paleo, Primal, Perfect Health etc.
2. Walk (gym or street) for 30 minutes three times a week.
3. Do it for 3 months.
4. Get your bloodwork redone.

At the end of three months, you will feel amazing. You will understand what fruit juice and bread does to your body. You will crave different things that are better for you.

There are literally thousands of resources for recipes, support, information etc on the internet.

I recognize the addiction anxiety in your post. If you check out the other "I just went to the doctor what do I do?" posts here, you'll see it too. You won't die without bread (you might die with it, so there's that) but it makes you high and it takes the very least amount of thought to use, and the thought of giving it up is terrifying. Just go without for three months, just as an experiment?

I feel like artificial sweeteners are the least of your concerns right this second. Be *mindful* of your intake, but worry about stopping completely down the road.

You're not alone. This happens to a lot of people. First there's the shock of diagnosis, which makes people panic. Then there's the mountain of information to climb (but pick one of the above diets and you will get the Cliff's Notes). Then there's bread panic. Then there's "ooh I'm so grouchy" which lasts a week and is not a reason to stop. Then comes having to smack your coworkers away when they come sniffing around the delicious lunches you've made for yourself because sandwiches aren't an option anymore.

Obviously, if it wasn't hard everybody would be doing it effortlessly, but trying it out for three months to see what it does for your health (and anxiety, because there's a link) is a small digestible chunk of time. You will learn things from it. That's good! That's something to look forward to!
posted by Lyn Never at 7:28 AM on March 13, 2013 [2 favorites]

You can also ask her for a Metformin prescription. Metformin has been shown to work very well as a diabetes preventative as well as for management.
posted by fingersandtoes at 7:31 AM on March 13, 2013

It's not your fault. It's not your fault. It's not your fault.

All sorts of studies have shown that all the metabolic and even behavioral factors that go into difficulty with weight loss are largely inherited. So step 1: forgive yourself so you can focus on playing with the hand you've been dealt.

And if your doctor is shaming you (which is sadly not unlikely), switch to a different doctor. You deserve someone who is there to help you. The phrase to google and ask doctors about during phone screens is "health at every size".

I've heard a lot about the benefits of eating a high-fiber breakfast. People tend to suggest oatmeal, but if you want to really focus in on what works for you, you can get one of those little drugstore finger prick blood sugar testing kits and see which possible breakfast foods make your blood sugar spike and which don't. Then you can adjust your habits accordingly. I'm not saying you should test your blood sugar forever - just during this exploratory phase of the process.
posted by 168 at 7:32 AM on March 13, 2013 [5 favorites]

I think the first thing you should do is start tracking what you eat. There's lots of free websites and apps you can download to track what you eat. Keep track of how many carbs you eat per day.

Yes, sugar is not good for you, but you need to limit all carbs. Fruit juice is just sugar, eat whole fruit instead. You could also try mixing fruit slices in sparking water.

I'm in a similar situation as you (type 2 runs rampant in my family, i might have pre-diabetes, i have PCOS). I avoid pasta, all types of bread, cereals, rice and white potatoes, except as an occasional treat. It was really tough in the beginning, but now I find that for the most part those foods are not filling, in addition to not being good for my blood sugar. Track the amount of carbs you are eating in your current diet for a comparison.

Replacement foods, like breads/tortillas/etc that claim to be low carb I am not a fan of because I don't think it encourages you to change your diet, and it feels like eating diet food. Try introducing new foods into your diet, try new vegetables, cook food in new ways, make your own protein bars, etc.

You shouldn't be ashamed. This isn't necessarily something you have done to yourself, and you're lucky enough to catch this now so you can make healthy changes! There's so much misinformation out there about diet and nutrition it can feel impossible to know what is actually healthy for you.

In short, avoid bread, pasta, rice and other carbs, eat lots of veggies and protein, move more. You'll be fine.
posted by inertia at 7:34 AM on March 13, 2013 [1 favorite]

Take heart! It really does get easier to stay off sugary foods after a week or two of temperance. The insane craving to inhale 2000 kcals of donuts right now subsides.
posted by qxntpqbbbqxl at 7:39 AM on March 13, 2013 [1 favorite]

Speaking to the post-traumatic dieting state of mind, I would not pick a low carb diet as suggested above, that will very likely put you back in the dis-ordered eating anxiety frame of mind and you're likely to avoid the whole thing. Just make different choices when you can:

* Pick sweet potatoes (diabetic superfood!) over white potatoes, eat corn tortillas instead of wheat, choose brown or wild rice or quinoa instead of white rice.
* Make sure you have lots of healthy snacks throughout the day to keep your blood sugar stable
* Treat yourself but not every day.
* Look into treats like homemade flourless cakes and use the stevia baking blend.

Think of it as far as one choice, one time rather than a three months worth or a whole lifetime of choices so it becomes a natural habit rather than a diet.

You will be ok!
posted by Kimberly at 7:39 AM on March 13, 2013 [4 favorites]

I had a similar experience, and it totally sucked.

My immediate reaction was to eat all the things and to feel really guilty (both for current & past eating).

However, I have since come to realize that I totally didn't get these eating habits all by myself and I can be a good, worthy person even as I try to manage them.

Since we started the blood sugar testing, my doctor has said that this is one of the concrete ways GPs can help their patients avoid Diabetes... By making them aware and helping them to shift their eating habits.

Exercise is definitely a part of it and what you eat is another.

You don't have to change perfectly or completely to improve your health. Incremental change can still make you healthier.

Getting a consult from a dietician or nutritionist might help. I got one from my husband's Employee Assistance Program, and later one from a hospital clinic I was referred to for a related issue.

If a nutritionist isn't available, try looking at the Canadian Diabetes Association's meal planning guide.

Be gentle with yourself. You're not a bad person for having high blood sugar.
posted by Heart_on_Sleeve at 7:48 AM on March 13, 2013 [2 favorites]

Hi there! I'm very fat with a complicated history with dieting and a recent bloodwork indicator of pre-diabetes! Nice to meet you, friend!

I did go to a nutritionist. I was (pleasantly) surprised that she did NOT want me to go OMG NO CARBS EVERRRRRRR. She wanted me to limit myself to no more than three carb servings per meal, or about 45 grams of carbs per meal and make sure I wasn't skipping meals. (Note, as you probably know, a serving is probably less than what you think it is, and one slice of bread can easily be 2-3 of your carb servings.) I would highly recommend going to a nutritionist to get a plan that works for you, though. I told her at the beginning that I was not interested in pursuing weight loss in and of itself because that sends me into some bad mental health places, and she was fine with that.

She also prescribed a monitor, which is kinda fun (????) to play with. That is, if I overdo it at a meal and check my blood sugar two hours later and see that it's over 140, well dang - that's some immediate feedback I can see to make sure I don't do that again.

All-in-all, I've found it pretty easy to manage, even with years and years and years of dieting anxiety stuck in my brain. And my numbers are looking great.
posted by ferociouskitty at 7:48 AM on March 13, 2013 [7 favorites]

Ask your doctor what she recommends that your carbohydrate intake be - as in grams per day. I found this to be a key piece of information when I was in a similar situation.

Then for a few days track everything that you eat - look up the carb counts and record them. This is a little shocking but very helpful, you start to get your head around where the carbs are and what changes you need to make.

At a point when I was cutting back on carbs but not quite going Atkins low carb, I searched for the lowest-carb bread I could find (that wasn't "low-carb" bread) and used that to make a breakfast sandwich with ham and egg. For other meals I cut way back on rice, potatoes, pasta and bread. On the weekends I'd cook one meat, and several veggies, and then combine them in different ways to make lunches.

I've kept the diet coke habit though - and I switched to splenda in my tea.

There are low-carb forums - might be worth checking into them for advice and support.
posted by bunderful at 8:04 AM on March 13, 2013

When I was a marathon-running active person, my doctor found during a physical that my cholesterol was a little high. Nearly everyone I'm related to has high cholesterol so that experience showed me that some of this is pre-determined. However, I focused on working out one more day a week and eating more whole grains and my cholesterol dropped, which showed me that yes, some of this stuff is pre-determined but I have a role to play in it too.

Try to see the positive. A lot of people don't even know that they're at risk for diabetes. We found out that my grandmother was diabetic when she passed out multiple times and had to go to the hospital, where they found that her blood sugar was 600+. However, you know you're already doing a better job than people who don't know. Plus, as you can see from my experience, I really think that knowing is empowering. For me, it was kind of about becoming an adult and realizing that yes, my family gave me some stuff for which I am responsible but I can do something about it.

Do you cook? I definitely eat healthier when I cook. I think that even the crap I bake for myself is healthier than the stuff I would buy in a store or eat at a restaurant. Plus I enjoy cooking - I feel proud of myself and more wholesome after cooking. So if you're not already cooking your own meals, you definitely should be. Plus it's just good to see, yikes, that's a lot of butter, that's not a lot of salt, who knew these things together taste good, etc.

I have found that sometimes I just like to eat a lot of something, so when I do, I try to get a bag of carrots or grapes. I also like to have something to eat before bed (because I am the worst) so I might have a bowl of cheerios or a yogurt rather than ice cream. So think about your habits and how you can re-tool them.

Don't stress and don't be scared. You didn't cause this and you're going to be alright. If/when you have a setback, just think about it as another part of your journey. Some people get into a mindset where they think, I'm going to go to the gym 5x a week and then one week they go 4x and think, I suck, I'm never going back. Don't be that guy. If you fall off the wagon, just hop back on.
posted by kat518 at 8:08 AM on March 13, 2013

I am gestationally diabetic, and probably heading to type 2, and it is a pain in the ass because I am constantly thinking about food. With my first pregnancy, I was mostly diet controlled (which meant eating almost no carbs); with this second one, I'm on insulin, which requires me to eat a bunch of carbs to not bottom out my sugar. It's all doable, but it requires effort; having a baby in my uterus tends to make it easier to deal with the effort, as does the fact that the baby will come out eventually and then I won't be so scared of everything's effect on the baby.

Having said all that: if you can afford to see a nutritionist, or get insurance to pay for it (most of them will with a prescription) it makes a huge huge difference in my experience. They can help you form a plan and help you understand what the food is doing and why, and they can help you understand that you're talking about a lifestyle change which means less carbs but doesn't mean NO BREAD EVER AGAIN OMG. As my doctor keeps saying, its about long term trends not one time spikes, so it isn't as if you can't eat a piece of cake on your birthday (but maybe you won't want to depending on how that makes you actually FEEL).

It'll be okay. You'll be okay. This isn't your fault. But it sounds like working with a nutritionist so that you have a specific plan, combined with working with your therapist, would be really helpful to you instead of just trying to cobble it all together alone.
posted by dpx.mfx at 8:14 AM on March 13, 2013

This is a real time of opportunity for you. You have been given an early warning of diabetes, which means you can prevent it. It seems really simple to list the sorts of changes you need to consider (eat fewer carbs! increase your activity!), but in reality change is difficult. Important, necessary, potentially life-saving, but still really really difficult.

Consider getting some help; if this were easy to do on your own everyone would do it. (and everyone does not). Ask your doctor for a referral to a registered dietician, or to a diabetes educator. See if your gym has personal training, or consider signing up for a class (harder to skip going if you think of it as an appointment). Do you cook for yourself? If not, are there local cooking classes?

Best of luck!
posted by maryrussell at 8:21 AM on March 13, 2013

IANAD, IWPD (I was pre-diabetic)

1) You're not going to get diabetes overnight. Not even in three months. Probably not in the next three years. This is reversable and you have time.. but of course it's better to get going now!

2) re: sugar drinks: so here's my story. I used to drink a truly insane amount of Coca-Cola. (therapist at one point said it was basically self-medicating for depression, in a weird, goofy, sad way; another story!) I eventually managed to kick it - 4 years after I was pre-betic diagnosed - by first stepping down to Sprite (cutting out the caffiene, which was causing anxiety issues) and then to fruit juice (which, ironically, tends to have more calories per ounce than soft drinks). Then: ice water. I was still drinking the same quantity of fluids (and we're talking in the liters) per day, but it was just water.

Weight started coming off at about 5 pounds a month, with no other changes. I've made some other small changes to diet and exercise and I feel that that has improved my overall health and helped keep the weight loss going, but it was the sugar drinks that were the biggest thing. I still eat carbs sometimes. I drink beer. Doesn't seem to matter: as long as I keep the sugar away, weight comes off.

So my feeling is: yeah, sugar drinks are really that bad. I try some orange juice or cider sometimes nowadays, but they usually taste too syrupy for me. I haven't had a soft drink in forever (tho sometimes I crave. CRAAAVE). Am down 80 pounds so far over the last year and a half, with another 20 to go. My trigyciderides - which were WAY high, and are another pre-betic warning sign - are amazingly, fantastically good now. AC1 is 5, which is still kinda high but out of the pre-betic range.

Take heart!
posted by curious nu at 8:28 AM on March 13, 2013

You'll have to figure out what works for you. You have to balance getting good nutrition with an appropriate number of calories with being able to feel not hungry all the time.

The best advice I can give is to look into the glycemic index of food, how it works and what foods are and aren't good for stable blood sugar.

If you are pre-diabetic, you know that blood sugar regulation is a problem that your body has. And it's a vicious circle- fat secretes hormones that make you insulin resistant, which creates more fat, and so on. So step one is to lose some of the fat. An Atkins type of diet is good for this. Read the book and follow the plan. It seems weird, but it is temporary and effective. Once you get out of the pre-diabetes danger zone, you can adjust the diet to something that is effective long-term.

(I would also suggest that not wanting to know how much you weigh is not making peace with your body, but rather avoiding something you know bothers you. If you were at peace with what nature has given you to work with, it wouldn't matter. It could be 125, 160 or 300 for all you cared. But you do care, and avoiding the number isn't going to stop the anxiety. It just keeps the anxiety a little quieter.)
posted by gjc at 8:38 AM on March 13, 2013

I really recommend checking out Mark Sisson's Primal Blueprint and his website You will find lots of information that will both help you and ease your guilt about how you got where you are. His system also allows for lots of delicious food, which makes things easier to handle.
posted by rpfields at 9:06 AM on March 13, 2013

gjc, respectfully, not knowing one's weight when it becomes something to fixate on can be a huge help. As someone in recovery from an eating disorder, I haven't known my weight in at least 5 years, and it's basically removed a big source of anxiety. It sounds like it's helping the OP, too.
posted by fiercecupcake at 9:15 AM on March 13, 2013 [3 favorites]

gjc, scale anxiety is a real thing, and many people find that they are more easily able to engage with their health when they don't know the number.

OP, I am much like you, and I re-normalized my blood sugar (and stabilized my depression/anxiety, and got my blood cholesterol down into normal levels, and ended my high blood pressure, and lost a pretty good chunk of weight) by eating sort of paleo-primal-low carb. I basically eat meat, eggs, fish, fruit and vegetables. It's hard at times (goldfish crackers and have a horribly dysfunctional relationship, I can't even have them in the house) and if I fall off the wagon, it's a long slow climb back up. Exercise was also a critical component of this, but I found that the better eating was a prerequisite to having enough energy to exercise.

I also spoke with a dietitian, who encouraged me not to discount the social importance of food and to consider portion sizes and moderation. . . for everything except fruit juice and soda. "There is no reason for anyone to drink that stuff, it offers no benefit whatsoever," she said. "The only way you should be drinking fruit juice is if it's been turned into wine." Nowadays, I drink water, and sparkling water with fancy cocktail bitters added, both of which I find delicious.

Memail me if you want to know more. It's a struggle, for sure, but my dad has type II diabetes with an A1C of over 9, and it really affects his health. I do not want that.
posted by KathrynT at 9:18 AM on March 13, 2013 [1 favorite]

Type 2 here. I totally remember that horrible feeling when I was first diagnosed, and I want to give you a hug because it is really really overwhelming. Don't be like me and ignore the problem for years; it will only compound trying to control your blood sugar levels later (sigh).

I found this book (The First Year Type 2 Diabetes: An Essential Guide for the Newly Diagnosed) super-useful. It's by a patient advocate, and it basically walks you through your first year dealing with the emotional complications as well as the practical stuff of having diabetes/pre-diabetes.

You might want to go to Walgreens or your local drugstore and pick up a blood glucose monitor (they have some that are like $20). They seem really scary at first (I dislike needles a great deal), but the pokes are quite shallow. I am numerically oriented, so it really helps me to work out what things affect my blood sugar.

I know it sounds completely awful when you're first trying to wrap your head around it, but you learn to not miss refined carbs and bread and such. At first I was like, "But delicious breads! Potatoes! Rice!" but to be honest I feel like shit when I eat them now, so that helps me stay away from them.

Re: physical activity, start with walking, outside or at the gym. If you have a smartphone, download FitRadio and listen to some ~DJ curated~ tunes in the genre of your choice. It's low-impact, and it will make you feel better. If you can enlist a friend in this regard, all the better.

Memail if you ever want to talk.
posted by calistasm at 9:29 AM on March 13, 2013 [2 favorites]

I can't speak to the rest of your diet, but I've had success replacing sugary drinks with plain club soda, or club soda with a squirt of lemon or lime juice. I found that I wasn't actually craving the sugar, I just like the fizziness. It's a little bitter at first when you're used to Dr. Pepper or whatever, but you might find it a decent replacement instead of plain water all the time.
posted by no regrets, coyote at 9:43 AM on March 13, 2013

Two words: clean eating

So I am trying to eat a lot healthier while losing fat and gaining muscle. I've done A LOT of reading on clean eating and it just makes the sense. Clean eating is basically eating only whole ingredients, if it can't be made at home, you shouldn't buy it or eat it. If it never expires, you don't want to eat it. You can find a lot of recipes online for clean eating foods ( for example). For eating, and working out, I'm following Jamie Eason's program. It's completely free and online ( I don't take any of the supplements though. It's definitely not required it see results don't think you need them. She has a workout for everyday and even says no cardio the first four weeks.

I am following her eating plan for the most part too. I've upped my protein intake BIG TIME and I do feel better. The eating clean meals every 2 1/2 to 3 hours does take planning but it means I'm never hungry.

So for example, today I had eggs and half an avocado for breakfast at 7:30, for snack I had a protein blueberry muffin that I cooked with whole wheat flour, a couple bananas, eggs, protein powder, blueberries (obviously), applesauce, some EVVO, and some spices. For lunch I'm having broccoli and chicken chili that I made in the slow cooker with kidney beans, cannalini beans, chicken breast, pureed spinach, diced tomatoes, some cayenne pepper, and hot sauce. For snack at 3:30 I'll have a greek yogurt that's unflavored with a banana mashed into it. For dinner at 6:30 I'm going to have salmon and asparagus. Then around 9 I'll have 3 hard boiled egg whites. I try and drink a gallon of water a day, which seems like a lot, but if you keep water at your desk to sip on throughout the day, it's really not so bad.

So it's A LOT of food but I prep on Sundays and don't have to worry about it during the week (except for dinner but that's normal). I just try and make sure that I get at LEAST 10 grams of protein per snack and at least 25 per meal. It's so worth it to be able to just grab your whole day from your kitchen, throw it in your work bag and go.

A lot of people think the foundation of losing weight and getting healthier is a lot of cardio with a little bit of weight lifting, and eating healthy from time to time when in fact, the reverse is true. Getting healthier and losing weight are mostly reliant on what you eat followed but weight lifting and then cardio is the smallest portion.

I LOVE sweets, candy, donuts, soda, ice cream, CUPCAKES!! You name it, I love it. "That's too sweet for me" has NEVER been something I've said. Since clean eating, the sugar cravings have subsided and trust me, I didn't think that would ever happen to me.

I enjoy the weight lifting in a way that I never enjoyed cardio. Plus, having the exercises all planned out really helps me when I go to the gym.

If you can afford it, I would really recommend a fitbit pedometer. It motivates me to get at least 10,000 steps a day and counts a lot of other fun things like stairs, calories, distance.

Also, make an anonymous instagram account if that's something you're interested in. I have one and use it to upload pics of my food with hashtags like #cleaneating #protein. Everyone in the fitness community I've come across on there is suprisingly supportive.

Please please don't think this is your fault or blame yourself. Life happens, experiences happen. There are so many different things going on in your body. Nothing you did or didn't do in particular led you to this moment but now you get to decide how you want to go forward and I think that's empowering :)

Please memail me for support or if you have questions or you just want to talk. Good luck, it's not easy but it's well worth it.
posted by whitetigereyes at 10:58 AM on March 13, 2013 [3 favorites]

You will find a TON of information and support at Reddit's Keto forum.
posted by bink at 11:14 AM on March 13, 2013

I lowered my carb intake a step at a time, because making major diet changes is too hard for me. I'll give you the list of changes that I made... but I started out with the water and ready snacks for a couple of weeks, then added another step for a while, etc. Throughout the whole adjustment period, I had lots of protein foods on hand, plus some vegetables like carrots, celery and red peppers all cut up and ready to eat. I didn't concern myself with fat intake, and I paid no attention to calories.

In any order that makes sense:

Drink more water throughout the day. It lowers the concentration of glucose in the blood.
Read up on glycemic load and glycemic index.
Cut out anything that makes me want to eat more, more, more of it.
If I'm starving, make myself eat a high-protein food and then WAIT before eating more.
Eat more often: every 2.50 hours works for me.
Rid my house of foods I want to avoid. Segregate the treats my husband "needs."
However much rice, potatoes, cake I usually eat -- I cut that in half.
However much physical activity I'm used a little more.
No fruit unless I've just had some "real" food, because fruit sugar is sugar (but has beneficial fiber)
Small portion of dessert now and then-- no sweets on empty stomach, ever.
Switch over to whole wheat bread and whole grains. WW bread isn't dramatically better for me, but it's not as tasty.
No sweet drinks at all.
Get very strict about the "white carbs" -- white potatoes, pasta, rice
Have one piece of bread per sandwich.

You get the idea. What really helped was having so many different ways to do things right. I was able to say, "Nice job...ate half the bun with the burger, ignored the fries, drank water, had a protein snack before I got too hungry." Okay, so I was sedentary that day...I still did well. After three months of this progress, I tested out as "high normal" instead of pre-diabetic.

It got easier after a few weeks, but I really missed my high glycemic foods at first.
posted by wryly at 12:27 PM on March 13, 2013 [3 favorites]

Minimal carbohydrates and lots of exercise (take a rigorous one hour walk every day). My sister did that successfully.
posted by Dansaman at 12:45 PM on March 13, 2013

I am a pharmacist who works with patients with diabetes.

First off, you're doing great so far by asking this question and wanting to make changes to improve your health! Diabetes (and pre-diabetes) can be a scary thing and it's important to make changes now to prevent any long-term problems. In 3 months, you can make some changes that would really impact you, but I wouldn't try to do everything all at once.

If you cannot afford to pay for a nutritionist, please find a diabetes education program in your area. Call the centers that are reasonable distance for you and ask if they charge any money for the class. The fee usually isn't much, if at all. These classes are usually taught by dietitians, nurses, and pharmacists. A lot of the advice they give to people with diabetes is the same advice that people with pre-diabetes would benefit from. There are also a lot of websites out there that help people manage their diabetes; I like this one because it has specific recommendations and actions that you could do. What works for some people might not work for you specifically, but it's important to know the general recommendations from an official source.
posted by watch out for turtles at 3:45 PM on March 13, 2013

I have Type 2 Diabetes and it sucks. I've developed all sorts of crappy chronic diseases/conditions that go along with Type 2. Don't be me.

There is tons of good info up-thread.

One of the low carb diets mentioned above will help (Atkins, South Beach, etc.) you in finding out what you can and should not eat. Note: I did not say cannot eat, because of course you can. And when you do eat something on the "cannot/should not" list don't beat yourself up about it. There's always exercise to alleviate the carb load, there's always tomorrow to start over. Or you can even treat it as a once-a-week treat. Do NOT get into the "I can't have anything good ever again!!" mindset because it's bullshit. Moderation is key.

Get a blood glucose monitor and learn to use it (most are really simple). The monitors tend to be free as long as you buy the testing strips to go with them.

Log your food intake and your blood glucose readings. You'll learn what spikes your BG and what doesn't. Frustratingly, it can be up one day and down another with the same damn food. There are free websites you can do this on or you can use a notebook.

Walking is really good for you, swimming is even better.

Feel free to MeMail me and good luck!
posted by deborah at 6:11 PM on March 13, 2013

FWIW, when I was diagnosed 18 months or so ago, my A1C was an off-the-charts 15.6. Now (and for the past year), it's a 5.6. No, that's not a typo -- it went from crazy-diabetic to normal. Yes, I'm on oral meds, but the biggest change (and yes, I get hating change) was being absolutely 100% vigilant with carb counting. 45-60 grams at any meal, 15 for any snack/dessert. It's so much easier to just be vigilant all the time and then you don't have to think about it. And I'm a super-picky eater who not only hates to cook, but basically won't cook, so there's always hope!

For the first month, I filled those psychologically "starving" moments with low-fat cream cheese on celery, hard-boiled eggs and almonds. The protein kept me from wanting to snack on my own elbows. A carb-counter is probably shelved by the diabetic supplies at your pharmacy or grocery show.

Remember, it's not "sweets" but carbs. Bread. Pretzels. Pasta. Etc. If you love pasta, look for Dreamfield's brand of pastas. I was dubious, but my Endocrinologist's nutritionist on staff said the claims are pretty much true. Avoid fake foods. Aim for things that actually grow (like veggies) and avoid more highly processed things.

Diabetes for Dummies is pretty good and recently updated, and your public library system likely has great easy-to-read books on the subject. Also, check out Diabetes Sisters to see if there's a PODS group in your area.

Also, call a few endocrinologist offices in your town and ask them if they know of any diabetes support groups. We have quite a few -- they're generally run by diabetes education counselors and nutritionists.

Walk. Up stairs. Across parking lots. In the mall. Keep moving. It's hard to eat unhealthy foods and walk at the same time without spilling most of it. :-)

Don't feel you have to go by the scale. Find a pair of jeans that fit snugly now. Note as they become less snug until they are too big to wear without a belt. Lather. Rinse. Repeat.

Hugs and good luck!

And almost all the advice up top seems excellent. (And while I don't believe you will go from diabetes to pre-diabetes in just three months, you can dramatically cut your risks in three months.)
posted by The Wrong Kind of Cheese at 10:51 PM on March 13, 2013 [3 favorites]

Hey, I'm popping back in here a few days later because your question has really stuck with me. I read it again really carefully and here are the phrases that haunt (yes, haunt!) me:

I had been making steps towards eating healthier and generally living a healthy life. ...Also, I will admit that, at least over the past few months, I have been going a little overboard with the sugary foods-- donuts, candy at the office, etc.

I literally thought that if I just ate less cakes and cookies and shit, and worked out more, I would be fine.

But my takeaway from that phone call was that I basically could not have sugar ever again, or at least for the next three months, and I would be doomed to water, and nothing but, forever. I got very anxious about this.

-Do I really need to be that hardcore?


It is completely, utterly normal to freak out when a doctor is telling you that you have to change your entire lifestyle. It's a really scary thing to hear.

But I also feel, and I say this as someone who was once in your position, like you sound like a junkie. You sound like you're in the bargaining stage of an addiction.

Sugar and, to a slightly lesser extent, processed foods like muffins/bagels/etc, well... they are not like other foods. Sugar affects our brain in scary ways, and it often creates addicts out of people who are sensitive to its charms. I won't go into the neuroscience of it here, but this book is a good starting point.

The way that you talk about sugar in your entire post hit home with me, because I used to be like that until I cut it out entirely. One time when my friends and I went to a log cabin in the mountains, we forgot the bag with all the cookies and treats. I had a full-blown panic attack at the idea of being without sugar and processed foods for 3 days straight. I was grouchy and miserable until finally someone got so fed up with me that they drove 2 hours into town and got me a zillion peppermint patties.

It also sounds like you may possibly lean on food to mitigate anxiety, denial and depression. These are issues to discuss with your therapist, because again, sugar is creates very strong dependencies as well as weight issues, and the cycle of Eating To Feel Better-Gaining Weight-Getting Depressed-Eating To Feel Better can be powerfully undermined if you cut sugar/processed foods out of your diet except in very small quantities, such as blueberries and blackberries for dessert or a square of dark chocolate once a day.

I'm trying to word this in a way that won't send you into a shame spiral. You're doing fine, you sought help, and you can turn your life around. But first you have to stop bargaining and accept that your lifestyle should probably change. I guaran-fucking-tee you that if you cut the garbage out of your diet, in 2 weeks you'll feel like a brand new person.
posted by zoomorphic at 6:45 PM on March 14, 2013 [2 favorites]

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