Traveling and Living With Prediabetes

Living with prediabetes is a new experience for me. I used to be one of those people who could eat whatever I wanted and still maintain a healthy weight. I never followed a diet. In my early forties, I did start to gain a few pounds, so I started going to the gym regularly and swimming laps two or three times per week to get back to my usual weight. I still ate whatever I liked, but I had to workout regularly so that I didn’t gain weight.

I went to my doctor for a physical each year, and my annual glucose test results were consistently within the normal range. Until one year, it wasn’t.

Something changed, and my glucose level shot up above the normal, healthy range.

Now, I’m one of many people who struggle with prediabetes and all the challenges of eating healthy and getting enough exercise to keep their glucose in a healthy range.

Here’s my story of dealing with prediabetes, starting with the unexpected diagnosis, changes in diet and exercise, controlling the condition while traveling, and how the struggle continues.

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What is Prediabetes?

Prediabetes means your blood sugar levels are higher than normal, but not high enough to be considered type 2 diabetes. Prediabetes usually occurs in people who already have some insulin resistance or whose pancreas isn’t making enough insulin to keep their blood glucose in the normal range.

So what’s the big deal if your blood glucose levels are a little higher than normal? Prediabetes often leads to Type 2 diabetes, the most common type of diabetes. Type 2 diabetes is a serious health condition that can put you at risk for other health issues, including heart disease, stroke, high blood pressure, nerve damage, kidney disease, skin conditions, eye damage, slow healing, and more.

I definitely want to avoid type 2 diabetes and the other health issues often associated with it.

My First Diagnosis of Prediabetes

When I received my first diagnosis of prediabetes in 2019, I was skeptical. How could I have prediabetes?

I was eating a healthy high-fiber diet
Did 30 minutes of yoga every morning
Exercised regularly (walking, hiking, and swimming)
Not overweight
Didn’t have high blood pressure
Quit smoking years ago
Have a low-stress life
No history of diabetes in my family

How is it possible that I have prediabetes?

My only risk factor for prediabetes was being over the age of 45.

Basically, I thought my lab test showed an elevated glucose level of 6.2 because I had been stocking up on carbs before or after hiking. So I stopped drinking orange juice and potato chips (my pre-hike guilty pleasures) but largely ignored the diagnosis.

My glucose levels had always been in the normal range, with my A1C at 5.2 to 5.5 for years. I assumed it was just my short-term bad habits that made it go up temporarily. But we know what happens when we assume!

In case you’re wondering here are the ranges for A1C test results:

A1C level below 5.7% is considered normal.
A1C level between 5.7% and 6.4% is considered prediabetes.
A1C level of 6.5% or higher on two separate tests indicates type 2 diabetes.

My Second Diagnosis of Prediabetes

I was traveling full-time, driving all over the US and Canada, spending winters in the south and summers in Canada visiting family. The most difficult times for me, trying to eat healthy foods and exercise, were the days I was changing to a new location, and I was driving all day.

Usually I spent long hours sitting at a desk and working on my laptop, but I got outside for long walks almost every day and went hiking regularly. I also swam laps when I could get a short-term gym membership.

The following year, I went to my annual physical and had my blood work done, and guess what? My A1C test result was STILL at 6.2, prediabetic WTH?!?! That got my attention.

When my new doctor called me to discuss the results of my test, she assumed I was overweight and said I should cut sugary foods from my diet as well as high-fat foods.

Um, no, I wasn’t overweight, and I didn’t eat many sweets. After she saw me again and realized my weight was not the issue at all, she suggested I follow the Mediterranean diet and get regular exercise (30 minutes daily, 5 times per week).

Getting Serious about Prediabetes

I read everything I could find about prediabetes, including causes of prediabetes, recommended diets for prediabetes (the Mediterranean diet is often mentioned), lists of low-glycemic foods, side effects of poorly managed prediabetes, and medications for prediabetes.

And then I read about Type 2 diabetes and all the health problems that could be associated with that serious health issue. So that got me even more focused on improving my diet and getting more exercise.

Remember, Type 2 diabetes can put you at risk for other health issues, including heart disease, stroke, high blood pressure, nerve damage, kidney disease, skin conditions, eye damage, slow healing, and more.

That’s when I knew for sure I had to make some changes to get my glucose back down to the normal range and my A1C result below 5.7 and keep it there consistently.

I started making a list of low carb foods and one for low glycemic foods.

7 Changes I Made To My Diet

In order to improve my diet and eat low-carb and lower-glycemic foods, I made these seven changes to my diet.

I stopped eating high glycemic foods by excluding the following from my diet: crackers, fruit juice, potatoes, white pasta, white rice, white bread, bananas, dates, dried cranberries, mango, pineapple, raisins, and watermelon.
Also, I stopped eating occasional treats or desserts like chocolate covered marshmallows, gelato, ice cream, chocolate cake, and cookies. I do still eat one or two squares of dark chocolate (with 85% cocoa) each day.
Since I’ve never been a fan of fast food I had no problem giving that up entirely. When dining out I stopped eating potatoes and asked if I could substitute a salad or vegetables instead.
I use honey as a sweetener rather than sugar, although I never add sugar to my coffee or tea. I quit that years ago after realizing how much sugar I was consuming with my coffee every day.
I introduced lower glycemic foods and low carb foods to replace the high glycemic and high carbohydrate foods I previously ate.

Rye sourdough bread or whole grain breads instead of white bread
Quinoa more often, instead of rice or pasta
Whole wheat flour instead of white flour
Brown rice instead of basmati rice
Brown rice pasta or quinoa pasta instead of white pasta (I also like durum wheat semolina pasta made in Italy) *
Dried apricots instead of dried cranberries or raisins for snacks
Blackberries or blueberries instead of bananas, mangoes, or peaches in my smoothies
Monk fruit blend or Erythritol instead of sugar for baking
Olive oil instead of butter (including for baking)
Low-fat dairy products instead of full fat dairy products

* Tip: Pasta cooked “al dente” has a lower glycemic index compared to overcooked pasta (but also remember to practice portion control).

I increased my omega-3 fatty acids intake by eating salmon, sardines, and trout fish more often.
I started eating more fresh vegetables every day, including snacks and in my morning smoothies. Spinach is one of my favorite veggies for smoothies, but I also like cucumber with parsley.

It was a struggle to change my eating habits at first. But I was committed to improving my health, and that helped motivate me to stick with it and eat healthier foods.

Changes to My Exercise Routine

I started walking more often and going for longer walks. My goal each day was to walk for one to two hours. If the weather was unpleasant for walking (I was in Calgary, Alberta, at the time), I walked around in the apartment building or ran up and down the stairs multiple times.

In addition to walking and continuing with my daily 30-minute yoga routine, I started doing more push-ups, planks, and free weights.

Improvement in My Glucose Level

When I had another A1C test done about five months later, it was at 5.8, a decent improvement. Still, I hoped to do better. I was also concerned about how I would manage my glucose levels while traveling.

Traveling With Prediabetes

When I started planning a month-long solo trip to Italy to celebrate a milestone birthday, I knew that I was unlikely to maintain all of my healthy eating habits. But I also knew that I would be walking a lot, so I figured, Why not eat pizza, pasta, gelato, torta tenerina (flourless chocolate cake), and Italian cheeses and pastries?!

I don’t know about you, but I like to try the local cuisine when I’m traveling because it’s part of the magic of leaving home and exploring a new place. Maintaining a strict diet is not something that goes well with “a month in Italy,” and I fully expected to gain a few pounds during my trip. I also expected my A1C to be around 6.0 after my trip to Italy.

Before leaving for Italy, I had an A1C test, and to my disappointment, it was already at 6.0!

I thought I was doing better with my diet and exercise. I would also get tested again after returning from my trip so I could compare my “before Italy” number to my “after Italy” number. With the pre-trip number already at 6.0 I now suspected it would be around 6.2 or 6.3 after my trip. But I was so WRONG!

Food and Exercise During a Month in Italy

I flew to Milan in mid-April and spent a couple of days there before traveling by train to Venice, Bologna, Cinque Terre, Florence, and Rome. At first, I avoided eating pastries and desserts because that little voice in my head told me to watch my diet.

But after a week or so, I caved. I ate gelato for an afternoon snack. Sometimes I ate pastries at breakfast. Several times I ordered chocolate cake for dessert after dinner. And I ate pizza and panini in Rome, and, of course, I ate pasta in every city I visited.

Since I didn’t bring my glucose testing kit with me, I didn’t know what my glucose levels were doing with all the extra sugar and carbs in my diet.

What I knew was that I felt great! I was walking a lot every day. Certainly, Italy is one of the best places for people who love to walk instead of drive around exploring a city.

After Italy Vacation A1C Test

To my surprise, when I had my A1C test done two weeks after returning from Italy, my result was (drumroll….) 5.5, WOW! I was surprised that it improved so much in such a short period of time.

I fully expected it to be around 6.3 or higher given that I was eating desserts, pasta, and pasties on a regular basis while in Italy.

But I walked a lot too, and I actually lost a few pounds, even though I ate gelato, chocolate cake, pizza, pasta, croissants, and other foods I avoid while at home. In fact, I ate fewer vegetables than I normally would at home.

I presume the thing that had the biggest impact on getting back to a healthy A1C test result was the additional walking I did in Italy. I do love walking, and when I’m traveling, I usually have no problem doing 10,000 to 20,000 steps per day and occasionally close to 30,000 steps.

The places I visited in Italy (Bologna, Cinque Terre, Florence, Milan, Rome, and Venice) were all pedestrian-friendly, so it was easy to walk more than I would back home.

Struggling Again After Vacation

I decided to try and replicate the Italy effect in moderation while at home. So I started eating pasta more often, but only good-quality pasta (made in Italy), and I was really careful with portion control.

I also ate low-carb ice cream occasionally, and I added roasted potatoes back to my diet, but otherwise I tried to follow the Mediterranean diet.

And I walked about two hours per day, hoping to keep my post-vacation weight steady (because my clothes fit better and I felt better) and maintain my blood sugar levels within a healthy range.

Then six months later, I had my A1C test, and I was back to 6.0 again. BIG disappointment.

Apparently I should live in Italy full-time if I want to keep my glucose levels in check AND get to eat whatever I want. Since that’s not happening anytime soon, I had to get back on track with my diet. I decided to follow the Mediterranean diet more thoroughly.

More Adjustments to My Diet

I took action immediately to reduce my intake of high-glycemic foods. First, I eliminated potatoes from my diet (again) and reduced the number of pasta servings to about once per week. I love Ragu Bolognaise way too much to give it up entirely at this point.

Then I stopped my habit of having a glass of red wine for happy hour. And with the added bonus, this saves me money too!

I also increased the number of servings of fresh vegetables per day. I think the veggie increase is most important for me because it helps me feel full, and the vegetables I choose to eat are all low-glycemic, like spinach, cabbage, eggplant, celery, cucumber, zucchini, and tomatoes.

Plus, I also eat several avocados per week and blackberries, raspberries, and blueberries almost every day. Celery with hummus is one of my new snacks since it’s more healthy than crackers and hummus.

After a month, I had another A1C test, and it was down to 5.8, so that was motivating. I have continued to follow the Mediterranean diet more closely and also walk an hour or more per day.

I started checking my fasting glucose levels more regularly using an at-home blood glucose meter, and it’s almost always in the normal range, below 100. When I took a road trip to Amarillo and did some hiking at Palo Duro Canyon, my glucose levels were down in the 70 to 90 range each morning.

I’m having my annual physical soon, and I’ll update this post with my A1C test results. I’m hoping it’s below 5.7 this time.

Of course, I’ve noticed that my glucose levels improve whenever I travel, so I feel it’s medically necessary for me to travel more often :)

Why Not Just Take Medication?

Some of you are probably wondering, “Why don’t you just take medication to control your prediabetes”.

First, I don’t like taking medication because there are inevitably side effects. I researched information on the prediabetes medication Metformin, and it has a LONG list of side effects. So that’s not going to be my first choice for treating pre-diabetes.

Basically, I’ll try everything else before I start taking medication for prediabetes.

And secondly, in my situation, I know that taking medication is simply a lazy solution. Sure, it’s easier to pop a pill than to alter my diet and get more exercise. But the best result for a healthy body is to eat healthy foods and exercise daily. And since I’m capable of doing so, I will continue improving my diet and exercise routine.

Third, the medication doesn’t resolve WHY my blood sugar levels are too high. I prefer to find a way to stop the problem from happening in the first place.

And finally, the side effects of eating healthy and exercising daily are positive rather than negative. It improves my heart health, boosts my mental health, increases my energy level, and generally improves my overall health and wellbeing. I really do feel better when I eat healthy foods and get exercise every day.

So that’s where I am now on this journey of managing prediabetes. I’m getting my A1C test done on Friday, May 31, so I’ll update this post when I get the results back.

UPDATE June 4, 2024: My A1C test result is 6.0, a lot higher than I envisioned the result would be. My new action plan is to reevaluate my diet to reduce carbs, eat more veggies, and increase my daily walking to 2 hours minimum.

Let me know if you have any questions or any tips. I’ve listed some resources below so you can learn more about prediabetes.