Diabetes, life and all that - personal diary

pavlosn

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@Andy12345

Just seen that I am legend as well apparently!

A bit premature.

I thought it was customary to snuff it first before becoming a legend.

I think until yesterday I was described as a Regular, a description most commonly associated with two things: verbs and bowel movements.

Pavlos
 
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Andy12345

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@Andy12345

Just seen that I am legend as well apparently!

A bit premature.

I thought it was customary to snuff it first before becoming a legend.

I think until yesterday I was described as a Regular, a description most commonly associated with two things: verbs and bowel movements.

Pavlos




lol perhaps they know something wont dont :)
 
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Nuthead

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@Andy12345

Just seen that I am legend as well apparently!

A bit premature.

I thought it was customary to snuff it first before becoming a legend.

I think until yesterday I was described as a Regular, a description most commonly associated with two things: verbs and bowel movements.

Pavlos
All hail and salute the legend :wacky:
 
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pavlosn

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Pavlos

You lucky man ! We in the UK long for climate like yours! No wonder the plants and flowers in the pics look exotic :)

I saw my DN today, she is well happy with my sugar control although A1C was 7.5 last time. 'l wait and see how it improves over the next three months. She debated the pro and cons of normal vs slow release Metformin. But is happy for me to stay on slow release.

She also wants me to stop testing as often as I am not on insulin and not T1.

Her advice was eat healthy and don't think about going hypo too much as I had become obsessed with it.

Regards

PSS
Just wait a few years and if those global warming scientists are right you may get your wish.

Unfortunately, if they are right, all we have to look forward to is desertification. :-(

Your nurse is happy with your sugars because according to NHS guidelines an a1c of 7,5 is the upper limit for a diabetic under good control. It is still a diabetic A1c and you should be able to bring it down further into the pre-diabetic ( 6- 6,5) or even non diabetic range (under 5,9).

I fear that you will not be able to achieve this if you follow you nurse's advise not to test your bloods and eat healthy, which I am sure she interprets as eat lots of carbs.

My latest A1c was 5,2%. Like many on this forum I managed to get this result by testing in order to educate myself on the effect different meals have on my glucose levels and adjust my next meal accordingly.

I test before and two hours after each meal and sometimes take additional counts at one hour after each meal.

I have a number of personal rules I follow to decide if a meal was right for me or whether it needs adjusting.

The first, and this is the only one I followed at the beginning when my levels were still working their way down gradually from a higher starting point on diagnosis, is that my levels 2 hours after a meal should not be more than 2mmol of my level immediately before the meal. If I failed to hit this target then that would mean that I would need to adjust this meal next time I had it by reducing carbohydrates until I did manage to stay within the 2 mmol limit.

Once my levels came down to normal levels I set myself the following upper limits for my glucose levels:
- fasting or before a meal 6 mmol
- one hour after a meal 7,8 mmol
- two hours after a meal 6,7 mmol
These limits are considerably below the limits recommended by NICE followed by the NHS and are non diabetic limits. In fact the aim is to maintain sugars in the non diabetic range for as long as possible so as to minimize the risk of diabetic complications. The limit of 7,8 mmol at one hour is not arbitrary; there are studies that show that above this level damage to our internal organs begins to occur.

I do not know when you were diagnosed or how experienced a diabetic you are.

Irrespective, my advise is that you do not buy in to the NHS dogma that diabetes is an inevitably degenerative condition, that t2s do not need to self test their bloods, and that lots of carbs are good for diabetics. They are not, they turn into glucose which we can not process properly our levels rise and this poisons our bodies.

In my opinion your nurse is right about one thing and that is that you should not worry too much about hypos, as you are only on Metformin.

It's not the lows that you should be concerned about its the highs.

Pavlos
 
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pavlosn

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Woke up at 4,6 this morning so it was an opportunity for me to test my rule of thumb that I should have a small snack before exercising when under 5 mmol to avoid either a low or a liver dump.

So I helped myself to a nice juicy mandarin orange before setting out on my 5km morning walk.

Just tested on returning and I am at 5,2 mmol, a count I am perfectly happy with.

ImageUploadedByDCUK Forum1416552015.553600.jpg


Have a great day everyone, after all it's Friday!

Pavlos
 
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pavlosn

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I guess it does not matter how long we have had this disease or how much we think we know about it, we are all capable of getting things wrong.

I am certainly no exception, as I found to my cost yesterday.

Luckily, nothing more serious than a few glucose counts that were outside my usual safety range but still frustrating because I failed to follow what I often advise others to do.

In fact, I broke not one but two of my rules:

I always advise that meals should not be skipped- I skipped lunch yesterday.

I also advise that we should always have plenty of healthy choices of food easily available for when the munchies strike. Our main supermarket shopping day is Saturday and yesterday was Friday afternoon so our fridge looked like an evacuation zone: I think I had the choice of chocolate, figs or milk.

It seems that once we put our levels out of equilibrium as I did by going too low yesterday afternoon at 3,8 , they swing the other way and oscillate a bit before settling back. A bit like a plucked guitar string or a pendulum that has been given a shove.

My post dinner readings last night were the highest I have seen in a while 8,6 at one hour and 10,8 at two hours.

By the time I went to bed these had settled to 5,3 but were up to 5,8 at waking.

ImageUploadedByDCUK Forum1416642933.435662.jpg


I managed to bring my glucose down to 4,7 following a game of tennis and riding my bike to and from the tennis club.

Now breakfast. I am not missing another meal; time I practiced what I preach.

Take care of yourselves

Pavlos
 
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Brunneria

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I guess it does not matter how long you have had these disease or how long we thing we know about it we are all capable of getting things wrong.

I am certainly no exception as I found to my cost yesterday.

Luckily nothing more serious than s few glucose counts that were outside my usual safety range but still frustrating because I failed to follow what I advise others to do.

In fact I broke not one but two of my rules:

I always advise that meals should not be skipped- I skipped lunch yesterday.

I also advise that we should always have plenty of healthy choices of food easily available for when the munchies strike. Our main supermarket shopping day is Saturday and yesterday was Friday afternoon so our fridge looked like an evacuation zone: I think I had the choice of chocolate, figs and milk.

It seems that once we put our levels out of equilibrium as I did by going too low yesterday afternoon at 3,8 , the swing the other way and oscillate a bit before settling back. A bit like a plucked guitar string or a pendulum that has been given a shove.

My post dinner readings last night were the highest I have seen in s while 8,6 at one hour and 10,8 at two hours.

By the time I went to bed these had settled to 5,3 but were up to 5,8 at waking.

View attachment 8361

I managed to bring this down to 4,7 following a game of tennis and riding my bike to and from the tennis club.

Now breakfast. I am not missing another meal,

Time up practice what I preach,

Take care of yourselves

Pavlos

Absolutely!

The number of times I have done this! Usually from 'forgetting' breakfast, but sometimes also through unexpected physical activity.

Thank you. You've reminded me I need to check my emergency snack supplies (coat pocket, handbag, desk drawer, boot of car.

I got caught out on Wednesday, and haven't been back up to 100% since.
 
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lizdeluz

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Yes, it happens. My swings aren't so extreme as they used to be, I'm aiming for Narrower Swings. Yay! A good aim in life!
Yesterday, 5.4 fasting
After swim, at 11:00, 8.9
Before lunch, 3.4
Waited too long to recover and inject:
Mid afternoon, 10.9
Before supper, 5.0
Mid evening, 3.4
Before bed, 5.9
01:09, 6.7, injected 1 U fast-acting
Today, fasting, 4.8

Can enjoy the ride, but will deselect the roller-coaster in future. :confused:
It's great to read your inspiring reflections.
 
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PSS

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Just wait a few years and if those global warming scientists are right you may get your wish.

Unfortunately, if they are right, all we have to look forward to is desertification. :-(

Your nurse is happy with your sugars because according to NHS guidelines an a1c of 7,5 is the upper limit for a diabetic under good control. It is still a diabetic A1c and you should be able to bring it down further into the pre-diabetic ( 6- 6,5) or even non diabetic range (under 5,9).

I fear that you will not be able to achieve this if you follow you nurse's advise not to test your bloods and eat healthy, which I am sure she interprets as eat lots of carbs.

My latest A1c was 5,2%. Like many on this forum I managed to get this result by testing in order to educate myself on the effect different meals have on my glucose levels and adjust my next meal accordingly.

I test before and two hours after each meal and sometimes take additional counts at one hour after each meal.

I have a number of personal rules I follow to decide if a meal was right for me or whether it needs adjusting.

The first, and this is the only one I followed at the beginning when my levels were still working their way down gradually from a higher starting point on diagnosis, is that my levels 2 hours after a meal should not be more than 2mmol of my level immediately before the meal. If I failed to hit this target then that would mean that I would need to adjust this meal next time I had it by reducing carbohydrates until I did manage to stay within the 2 mmol limit.

Once my levels came down to normal levels I set myself the following upper limits for my glucose levels:
- fasting or before a meal 6 mmol
- one hour after a meal 7,8 mmol
- two hours after a meal 6,7 mmol
These limits are considerably below the limits recommended by NICE followed by the NHS and are non diabetic limits. In fact the aim is to maintain sugars in the non diabetic range for as long as possible so as to minimize the risk of diabetic complications. The limit of 7,8 mmol at one hour is not arbitrary; there are studies that show that above this level damage to our internal organs begins to occur.

I do not know when you were diagnosed or how experienced a diabetic you are.

Irrespective, my advise is that you do not buy in to the NHS dogma that diabetes is an inevitably degenerative condition, that t2s do not need to self test their bloods, and that lots of carbs are good for diabetics. They are not, they turn into glucose which we can not process properly our levels rise and this poisons our bodies.

In my opinion your nurse is right about one thing and that is that you should not worry too much about hypos, as you are only on Metformin.

It's not the lows that you should be concerned about its the highs.

Pavlos

Hi Pavlos

Just logged on to the forum and saw you post. As usual lots of really good and valuable information and advice.

I was diagnosed as T2 in 2003. There was no information or education available those day. They put me on Metformin and subsequently Gliclazide was also added. I had a seizure in 2011 by going hypo probably due to Gliclazide and not having eaten lunch. I then came off Gliclazide.

Back in May 2014 I think I had another case of hypo and was taken to hospital. The ambulance crew thought I might be having a stroke. The consultant next day confirmed I could not have had a stroke. He couldn't say it was a mixter of hypo and a panic attack.

I have been very careful since then and am trying to look after my sugar. I hardly drink now days - not even a glass of wine. I am also on just one slow release 500 mg Metformin a day. The nurse was thinking of changing it to normal Metformin.

I have sometimes felt a bit dizzy/anxious but it has been probably false hypos as my body is getting used to lower BG.

I am going to keep testing and keep improving what I eat. However, I do think to avoid any false hypos I need to do the changes slowly !

Again any advice or info from you will be gratefully received.

Kind Regards

PSS
 

pavlosn

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Hi Pavlos

Just logged on to the forum and saw you post. As usual lots of really good and valuable information and advice.

I was diagnosed as T2 in 2003. There was no information or education available those day. They put me on Metformin and subsequently Gliclazide was also added. I had a seizure in 2011 by going hypo probably due to Gliclazide and not having eaten lunch. I then came off Gliclazide.

Back in May 2014 I think I had another case of hypo and was taken to hospital. The ambulance crew thought I might be having a stroke. The consultant next day confirmed I could not have had a stroke. He couldn't say it was a mixter of hypo and a panic attack.

I have been very careful since then and am trying to look after my sugar. I hardly drink now days - not even a glass of wine. I am also on just one slow release 500 mg Metformin a day. The nurse was thinking of changing it to normal Metformin.

I have sometimes felt a bit dizzy/anxious but it has been probably false hypos as my body is getting used to lower BG.

I am going to keep testing and keep improving what I eat. However, I do think to avoid any false hypos I need to do the changes slowly !

Again any advice or info from you will be gratefully received.

Kind Regards

PSS

Hi @PSS

Sounds like a good plan.

I agree that testing and adjusting gradually is the way to go.

My only comment is that since you have a tendency towards anxiety you need to be a bit careful not to let your meter became your master, A glucose meter is a very useful tool but nothing more than a tool. If you find that you get readings that are not as you hoped for, that just tells you that you need to make further changes to your diet. A meter reading that is too high is not some kind of failed test. Seen in this way a wrong reading is just as useful as a right reading; they are both feedback.

Also be prepared to see fluctuations in your readings rather than a continuous improving trend.

Finally trends in readings are much more important than individual readings in interpreting progress.

Good luck with your efforts.

I have full confidence in you.

Regards

Pavlos


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PSS

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Hi @PSS

Sounds like a good plan.

I agree that testing and adjusting gradually is the way to go.

My only comment is that since you have a tendency towards anxiety you need to be a bit careful not to let your meter became your master, A glucose meter is a very useful tool but nothing more than a tool. If you find that you get readings that are not as you hoped for, that just tells you that you need to make further changes to your diet. A meter reading that is too high is not some kind of failed test. Seen in this way a wrong reading is just as useful as a right reading; they are both feedback.

Also be prepared to see fluctuations in your readings rather than a continuous improving trend.

Finally trends in readings are much more important than individual readings in interpreting progress.

Good luck with your efforts.

I have full confidence in you.

Regards

Pavlos


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Hi @pavlosn

Having read your reply, I was feeling great.

I had a thought and decided to check my BG. At lunch I ate two slices of soya and linseed bread with Moong beans. Not a huge amount but enough. To my shock my BG was 3.9 and 4.1. Although I didn't feel hypo.

But seeing the numbers got me really worried and I quickly ate one digestive biscuit and two jelly babies.

30 mind later I was up to 5.7.

I really should have eaten a mid afternoon snack.

I guess the lesson is not to forget snacks! Life can be going well and then it throws a curved ball at you!

Kind regards

PSS
 

Andy12345

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Hi @pavlosn

Having read your reply, I was feeling great.

I had a thought and decided to check my BG. At lunch I ate two slices of soya and linseed bread with Moong beans. Not a huge amount but enough. To my shock my BG was 3.9 and 4.1. Although I didn't feel hypo.

But seeing the numbers got me really worried and I quickly ate one digestive biscuit and two jelly babies.

30 mind later I was up to 5.7.

I really should have eaten a mid afternoon snack.

I guess the lesson is not to forget snacks! Life can be going well and then it throws a curved ball at you!

Kind regards

PSS




personally i would not hve eaten the biscuit, your numbers were perfect, why spoil perfect lol
 
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cold ethyl

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I think it depends on how you feel at those numbers . I quite often feel a bit shakey and panicky around 4.2 ish and any lower I can get palpitations and full blown panic. That said, I wouldn't eat a biscuit or a jelly baby. I tend to have a warm drink with splash of lactofree milk or soya , a square dark chocolate and then a piece of cheese or slice of ham. I find protein far better at lifting my levels without an overshoot. It also works for my migraine attacks.
 
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Andy12345

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Andy

The anxiety got better of me!

PSS




hehe, remember the meters are not perfectly accurate. at 3.9 you actually be 4.3, unless you feel hypo id just enjoy being there, and there are better choices than biscuits lol
 
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pavlosn

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Hi @pavlosn

Having read your reply, I was feeling great.

I had a thought and decided to check my BG. At lunch I ate two slices of soya and linseed bread with Moong beans. Not a huge amount but enough. To my shock my BG was 3.9 and 4.1. Although I didn't feel hypo.

But seeing the numbers got me really worried and I quickly ate one digestive biscuit and two jelly babies.

30 mind later I was up to 5.7.

I really should have eaten a mid afternoon snack.

I guess the lesson is not to forget snacks! Life can be going well and then it throws a curved ball at you!

Kind regards

PSS
if you do not feel unwell 3,9 and 4,1 when on metformin only should be no problem BUT given your history and anxiety about hypos, I can understand why it was not a pleasant sight for you. Perhaps you should try to keep your levels a little bit higher just for your own peace of mind.

At least I hope the biscuit and jelly beans tasted nice. I hope they did not cause you to overshoot and end up too high later on

Perhaps next time you are in this position you might like to try just having a cup of tea with some milk and no sugar and see how that changes you levels first before going for the jelly beans.

I suppose having seen that nothing terrible actually happened even when as low as 3,9 you might start feeling a bit less anxious about lows. Although of course it does take time to change our mind sets.

Keep taking those baby steps and you will get there!

By the way did you check your glucose before lunch and how long after lunch was the 3,9?

Pavlos


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PSS

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if you do not feel unwell 3,9 and 4,1 when on metformin only should be no problem BUT given your history and anxiety about hypos, I can understand why it was not a pleasant sight for you. Perhaps you should try to keep your levels a little bit higher just for your own peace of mind.

At least I hope the biscuit and jelly beans tasted nice. I hope they did not cause you to overshoot and end up too high later on

Perhaps next time you are in this position you might like to try just having a cup of tea with some milk and no sugar and see how that changes you levels first before going for the jelly beans.

I suppose having seen that nothing terrible actually happened even when as low as 3,9 you might start feeling a bit less anxious about lows. Although of course it does take time to change our mind sets.

Keep taking those baby steps and you will get there!

By the way did you check your glucose before lunch and how long after lunch was the 3,9?

Pavlos


Hi Pavlos

You are right, recognising that nothing bad happened at 3.9 or 4.1 should help with the anxiety.

I have previously felt false hypo symptoms at much inheritance levels such as 5.6.

To me it means, my body must be getting used to lower BG.

I had lunch at 13:00 and I went down to 4.1 at 17:30 without any signs of a hypo.

Unfortunately I didn't check the BG just before the lunch.

Regards
PSS

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pavlosn

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Woke up extremely early today, must have been about 4:30 am.

What woke me up was the sound of the rain hitting our bedroom window. Must have been quite a strong shower for the sound to come through triple glazed windows.

I love being tugged in in bed on a cold(ish) night listening to the sound of the rain. It is a sound that takes me back to my childhood. We had a shed with a corrugated metal roof in our backyard just a few meters away from my bedroom window and I used to love the sound of the rain bouncing of it.

It's funny how certain sounds and certain smells seem to resonate within us and plug our emotional strings. I can never resist the smell of cut grass, baking bread and burning olive leaves. As for sounds, apart from the aforementioned rain, flowing water, crashing waves and perhaps rather surprisingly the sound of an orchestra tuning up before the start of a concert; it is such a wonderfully pregnant sound, full of the promise of delights to come.

I think of music as the most abstract of the arts but as the one that packs the strongest emotional punch. Perhaps it is this relationship between sounds and emotion which lies behind this. A beautiful piece of music, when well performed, has the power to transport us from our current reality and in some ways offer us a glimpse of God. Surely it is no accident that music plays such a large part in many religious services.

By the time it was time for me to get up, the rain had long stopped so I forced myself to go on one of my morning walks. After having a rest day yesterday, I could not afford to do so again.

This was a decision I came to enjoy soon afterwards, as what greeted my outside was a lovely morning with lots of sunshine and a fresh out of a bath feel; everything washed clean by the morning shower

ImageUploadedByDCUK Forum1416818172.781335.jpg

ImageUploadedByDCUK Forum1416818247.340299.jpg

ImageUploadedByDCUK Forum1416818585.465322.jpg


We are heading for a short break in Dubai over the New Year, as the wife was gracious enough to inform me last night.

ImageUploadedByDCUK Forum1416818688.745106.jpg


Last time we were there was four years ago ( the photo of Dubai creek with the worlds tallest building Burj Khalifa in the background was taken during that visit) and we really enjoyed our stay there then.

My comment that with the weather here being what it is we hardly needed a break to warmer climes was met by a stony silence and ignored with all the contempt my wife clearly felt it deserved.

We will be going there with some friends, another couple and their son who is the same age as our own son.
They came over last night so that we can "discus" our plans for what we will do during our stay there. For discuss substitute told by our wives - my suggestion that we should visit the world's largest indoor free-fall parachuting centre did not generate too much enthusiasm and, on second thought, perhaps just as well.

The shock of the night though, in a night full of surprises, started when they started discussing options for what to do on New Year's Eve itself.

I almost had a stroke when I herd what dinner at our hotel that night would cost.

You never saw a man converted to the attractions of greeting the New Year under the stars in the open desert in the Company of beduins so fast before.

I don't care if the beduins serve us camel dung for dinner, I am not paying 350 pounds per person to see in the New Year at the hotel's dinner dance.

So having travelled full circle, from the sublime to the ridiculous, I bid you farewell for now.

Back again soon.

Pavlos
 
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