i have recently been told I am borderline diabetic. My problem is working out how to reduce my blood sugar without losing weight. I am 157cm tall, aged 69, weigh around 48 kilos and cycle in excess of 200 miles most weeks. I eat a very healthy diet (according to the nutritionist I saw). After the diagnosis I cut out wine and became very strict about carbs – almost no sugar (one scone a week out with my cycling group), I eat minimal rice – mostly brown – less than once a week, and not much pasta – occasionally white, mostly brown – less than once a week. I eat homemade wholewheat sourdough bread – a loaf last at least two weeks. I have lost weight and struggle to maintain my weight at 48 kilos. I have had wine the last couple of weeks – one very small (less than 125m) glass most days. I feel frustrated and at times quite distressed at knowing how to deal with this. I become anxious about losing too much weight.

You’re in quite a different position to people on this forum, as we’re looking to lose weight. So perhaps your nutritionist is the person to talk to. When did you last see them? When you were told your diagnosis, what dietary advice were you given?

I’m not a specialist in this area by any means, but it sounds like you’re doing quite well on the carbs in food, though perhaps you should cut down even further and replace them with some calorie-dense food like cheese, full fat yogurt, nuts, meat and fish. I know cholesterol is a controversial subject, but as I understand it, the latest findings are that dietary fat doesn’t significantly increase cholesterol, your liver does that of its own accord. But you could swap animal fats like butter for olive oil, which is still very calorific but is regarded as a healthy fat. By the way, wine contains sugar, so it too contains carbs. You don’t mention fruit, but that too contains a fair bit of sugar.

Good luck.