Using low carb diet and sugar is still high, how do I get it lower?

[crazydiamond67]

I have been diabetic type 2 for 15 years. Im now 48. I have been on a very low carb diet for the past 2 months. Ive been on insulin (lantus) for 2 years, I also take glyclazide and metformin. My sugar levels are only stabalized from the hours of 3pm to 6pm. Otherwise im always high. I do not eat after dinner till brekky most days. On the occasion I might have a protein snack, like nuts or cheese. When I exercise my sugar level rises. I have just upped my level of insulin and there has been no change. Im at my wits end. I don't know where im going wrong. I have spoken to my doc about this. He has said a side effect of insulin is weight gain, just do more exercise. Well its not working, my weight is rising.. Im barely eating any carbs. I eat lots of veggies and meat, I snack on nuts, seeds. The only fruit I eat are berries, the occasional apple.

 

[Indy51]

Hi and welcome to the forum. I'm tagging @daisy1 so that she can provide you with the standard information for newcomers.

You say you are low carb - can you give us an idea of your intake for an average day so that we can maybe help you troubleshoot your diet? Have you tried using myfitnesspal or chono-meter to track you intake so that you can be sure you're sticking to the correct calorie limit for weight loss? You may find this nutritional calculator helpful:

http://www.phlaunt.com/diabetes/DietMakeupCalc.php

Sorry I can't help you with the insulin side of things, but hopefully someone else can.

If you take a look around the low carb diet forum you may pick up some useful information also.

 

[daisy1]

@crazydiamond67

Hello and welcome to the forum

Here is the information we give to new members and I hope you will find it helpful. Ask as many questions as you want and someone will come and help.


BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find over 150,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes-and-whole-grains.html

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to bloodglucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic

Note: This post has been edited from Sue/Ken's post to include up to date information.

 

[nigelho]

I have been diabetic type 2 for 15 years. Im now 48. I have been on a very low carb diet for the past 2 months. Ive been on insulin (lantus) for 2 years, I also take glyclazide and metformin. My sugar levels are only stabalized from the hours of 3pm to 6pm. Otherwise im always high. I do not eat after dinner till brekky most days. On the occasion I might have a protein snack, like nuts or cheese. When I exercise my sugar level rises. I have just upped my level of insulin and there has been no change. Im at my wits end. I don't know where im going wrong. I have spoken to my doc about this. He has said a side effect of insulin is weight gain, just do more exercise. Well its not working, my weight is rising.. Im barely eating any carbs. I eat lots of veggies and meat, I snack on nuts, seeds. The only fruit I eat are berries, the occasional apple.

I'm type 1 so use quick and long lasting insulins and I also take 6 X 500mg metformin SR tablets , 2 at each meal plus quick acting insulin. I see you only take long lasting insulin (lantus) so it might be time to replace tablets with quick and long lasting insulin regime.....ONLY a thought. Lantus is only background insulin.

 

[BooJewels]

I am T2 on insulin and have some ideas, but no time to post properly at the moment, but will come back to it later.

 

[BooJewels]

Right, I can sit and type now. There are several things in your post that struck me to comment upon.

You sound like you're in the same situation I was in a few months ago. You say your BGs are high, but didn't give numbers. Mine were fluctuating wildly between about 14 and 26 and I was on 2 meds and desperately trying to stave off the DN's suggestion that I needed to start insulin. In March this year, I had to concede, as whatever I did didn't make any difference. At the time she said that I'd gone too far for a background only insulin to work for me, so started me on a combination insulin - 75% background/basal and 25% short acting for meals. I take it twice a day before breakfast and evening dinner - slightly higher at night than morning and that has worked for me, we're still just titrating my dose up to get to a final level, I'm still a smidge too high - but we're taking it steadily to minimise the unpleasant effects of bringing BG down too fast. It sounds like maybe you're now ready for something similar - clearly what you're doing isn't working for you either.

As we started the insulin, we dropped one med and lowered the Glicazide - lowering in stages as the insulin was increased to minimise the fluctuation. I'm now off all meds and just on insulin. The fact that you're on insulin and Glicazide at the same time, they're both meds that have the potential for weight gain and will especially do so if your BGs are already too high.

If your BGs are high and you're taking insulin and it's not helping bring them down, then what it might do is just help store some of the glucose floating around, which is one of insulin's jobs in the body, so it sounds like it might be storing energy for you, but not allowing the glucose to be used, due to insulin resistance. You could also just be on the wrong insulin for you - my DN said there were lots of different types and if we didn't get it right first time, we'd just try a different one until we found the one that worked best for me. I was lucky that the first one we tried seemed to be just right for me.

Which brings me to the exercise - this is something I only learned recently with my own problem, I was exercising to try and bring it down, but it was raising instead, just as you have found. if your BGs are too high there is lots of unused glucose floating around in your blood, insulin resistance* will prevent the cells that are working hard as you exercise to have access to the energy that glucose would provide. Therefore your liver thinks 'hang on, she's working hard and needs some energy, I'll kick out some more glucose for her' and this will cause your BGs to rise even higher. When I hit this problem, the DN said to only exercise very gently especially if it was higher than mid-teens.

* I visualise insulin resistance as insulin being a gatekeeper on the cell - it creates an opening in the cell wall and nods to glucose to come on in. With insulin resistance, the insulin and the cell have had a barney and are in a sulk and won't join forces to create an opening for the glucose, which is hammering on the cell wall to get in and insulin turns it back 'nope, not today, move along' - 'but I'll catch up with you later to pop you in the store to try again tomorrow'. (Maybe it's just me that gives my cells back stories. )

If you're gaining weight, eating low carb but can't get your BGs down and are already on insulin, your doc should realise that exercise will potentially raise BG even further, so it seems odd that he should advise it and not offer a more suitable regime - but if he's like most of the doctors I encounter, if you're already overweight, they don't seem able to see past it and just assume you're a lazy liar not worthy of engaging their brains to try and get to the bottom of the problem. Thankfully, my DN has had the fortitude to stick with me and work on it together - it helps that I'm honest with her too - if I haven't done as much as I should, I tell her, so she knows when I insist that I've been working hard, she believes it.

Also bear in mind that protein becomes glucose too - just at a lower and slower rate than carbs, so eating protein instead of carbs won't necessarily be beneficial.

If you give more details of what you eat (and be honest, if only to yourself) and your BGs, we might be able to give more specific pointers. I was worried about weight gain on insulin, but I went on it in March and started my moderate version of LCHF at the same time and increased exercise as my BGs lowered (now a good session on the exercise bike will drop it by about 2) and have now lost 13lbs.

 

[Suercc]

Hello. I lost my control after 15 years of doing OK ish.
Went up to 19s 20s. I was told not to train or work out when bg is high as it is dangerous.
Strict low carb high fat regime has meant I am off many meds now
Good luck

 

[mekalu2k4]

not to train or work out when bg is high as it is dangerous

Yes. T2D folks should NOT train when BG is too high or too low. Either way it is not good.

 

[mekalu2k4]

hi OP,
How is your problem now? Hope you are feeling better. I want to share something that I came across.

I am fortunate to meet a very experienced, retired physician last week. He was born in Philippines and came to see his grand children to our place recently. I was discussing about diabetes with him over a cup of coffee at my home. He responded like this. "Most T2D patients will be fine with adjusting diet or exercise or the combination. They should be able to lead normal lives with or without medication. However, exceptions may be there and in those cases there are three ways of treating a patient - the first one is based on symptoms, second one is based on diagnostics test results, and the third one is combination of symptoms and diagnostics. Tell-tale external signs no doubt help the medics to find out the course of treatment, but some patients need additional investigations. Aged people with T2D should check their complete digestive system from end-to-end. Some patients may be suffering from abnormal bacteria or viruses fungi or parasites etc that might result in simple inflammation to range of problems. I would put down complete blood analysis, colonoscopy, urine and stool culture tests to see if there are any issues to be addressed. "

According to him all patients will not be able to tell all the symptoms exactly to the point doctor can understand completely. Sometimes doctors may not carry out all the necessary tests that are actually required to determine the root cause. He talked about Microalbuminuria, which is common in T2D folks. I had to google it about it later.

He also felt women and men are different in terms of types of hormones and their effect on Diabetes. He told that urine and stool kits are now available on amazon and not really expensive. I checked on amazon, they are all indeed cheap. But it is new knowledge to me, I need to research on test kits, what I can do at home, what benefits I get, and how to interpret etc. I will spend a few weeks of time reading about these things. These urine and stool tests do not require any pricking, so I believe I can do at home to see how I am doing internally.

What this means to you? Apart from your BS levels, Did you check current body fat percentage, lipid profiles, internal digestive system etc? May be you can ask your GP or nurse? It is only a suggestion.

I do hope you do something and feel better.

 

[fif1304]

Hi I've recently had experience similar to yours. I am TD2 and on multiple insulin injections that controlled my insulin well but not very well so I decided to reduce my carbs, having read about the great results other diabetics had had. I reduced my carbs from around 200 + per day under 100g and my blood sugar control went wildly out of control. I tried everything I could think of because my overnight blood sugars was climbing from around 8 to 12 + every night, something I had never experienced. I did the 3am tests religiously, ate protein bed time snacks and exercised daily to increase my insulin sensitivity but nothing seemed to work. I also worked on getting my nightime does of Levemir right becuase I thought that was the problem. Eventually two weeks ago, i started eating just a bit more carb everyday, I started eating berries and bananas as mid morning and mid afternoon snacks. I had never eaten snacks before because I didnt want to gain weight. Amazingly my blood sugars over the last two weeks have been between 6 and 7 at every meal. I think that my body reacted to the reduction in carbs by dumping glucose from my liver, especially overnight as I wasnt eating after 7pm in the evening until 7am the next morning. I guess It was thinking there's not enough to get this body working properly. I'm not saying that this would work for you, but it has worked for me and I feel so much better now. I think everyone's body is different and so we have to find out what works for us. Good luck I hope you find a solution to your problem. I have been diabetic for 18 years, initially diagnosed as TD1 for the first 16 years and then told I am TD2 with a pancreas that works perfectly., so a bit of a surprise.

 

[ringi]

I expect that "low carb" will only work for with reducing the protain and increasing the fat to get a full keto diet. This is very hard to do without expert surport. (Poeple like me who have only had Type2 for a short time, can get very good control just by reducing carbs without thinking about protain.)

The bad news is that this surport is very hard to find in the UK, the good news is that the experts have writen a book "The Art and Science of Low Carbohydrate Living". (They run a company "Virta Health" to provide the surport, I don't know if they will take on cleints outside of the USA or what they charge.) I expect you will learn a lot by spending a week reading their book, then make up your own mind.

The other expert that seems to get good results is Dr. Jason Fung, google will lead to his vidios, blog and book - however you MUST understand the risks of hypros before making use of his methods.

 

[DCUKMod]

Hi I've recently had experience similar to yours. I am TD2 and on multiple insulin injections that controlled my insulin well but not very well so I decided to reduce my carbs, having read about the great results other diabetics had had. I reduced my carbs from around 200 + per day under 100g and my blood sugar control went wildly out of control. I tried everything I could think of because my overnight blood sugars was climbing from around 8 to 12 + every night, something I had never experienced. I did the 3am tests religiously, ate protein bed time snacks and exercised daily to increase my insulin sensitivity but nothing seemed to work. I also worked on getting my nightime does of Levemir right becuase I thought that was the problem. Eventually two weeks ago, i started eating just a bit more carb everyday, I started eating berries and bananas as mid morning and mid afternoon snacks. I had never eaten snacks before because I didnt want to gain weight. Amazingly my blood sugars over the last two weeks have been between 6 and 7 at every meal. I think that my body reacted to the reduction in carbs by dumping glucose from my liver, especially overnight as I wasnt eating after 7pm in the evening until 7am the next morning. I guess It was thinking there's not enough to get this body working properly. I'm not saying that this would work for you, but it has worked for me and I feel so much better now. I think everyone's body is different and so we have to find out what works for us. Good luck I hope you find a solution to your problem. I have been diabetic for 18 years, initially diagnosed as TD1 for the first 16 years and then told I am TD2 with a pancreas that works perfectly., so a bit of a surprise.

Hi fif1304.

You have posted on a rather old thread, which certainly isn't against any rules, but experience tells me it may not gt you the best of visibility or lots of responses.

If you would like your post to be moved to create a new thread of your own, myself, or any other Mod could do that for you if you would let us know.

Good luck with it all.

 

[Kentoldlady1]

I expect that "low carb" will only work for with reducing the protain and increasing the fat to get a full keto diet. This is very hard to do without expert surport. (Poeple like me who have only had Type2 for a short time, can get very good control just by reducing carbs without thinking about protain.)

The bad news is that this surport is very hard to find in the UK, the good news is that the experts have writen a book "The Art and Science of Low Carbohydrate Living". (They run a company "Virta Health" to provide the surport, I don't know if they will take on cleints outside of the USA or what they charge.) I expect you will learn a lot by spending a week reading their book, then make up your own mind.

The other expert that seems to get good results is Dr. Jason Fung, google will lead to his vidios, blog and book - however you MUST understand the risks of hypros before making use of his methods.

Not sure I agree with this blanket statement. While I agree that support from hcp's may be difficult.to find in the uk, there is no need to join a company and pay for support either.

When using insulin you must have a good understanding of control. But it can all be done without paying for expert support.

 

[ringi]

Sorry it was not meant to be a blanket statement, clearly people like me who have had Type2 for a relative short time can get great results just from “eat less carbs” without having to think about types of fat, how much and what types of protein etc.

Also some people, who have had type2 for a long time, also get great results just from “eat less carbs” – but it can be a lot harder for a great number of people with long standing type2. crazydiamond67 has told us she has had type2 for 15 years and “eat less carbs” is not working for her.

Hence she needs to do detailed research herself reading the books written by the leading experts or find a hcp that has done so. Clearly her GP has not; otherwise she would be posting in the “Success Storeys” section.

 

[Kristin251]

Sorry it was not meant to be a blanket statement, clearly people like me who have had Type2 for a relative short time can get great results just from “eat less carbs” without having to think about types of fat, how much and what types of protein etc.

Also some people, who have had type2 for a long time, also get great results just from “eat less carbs” – but it can be a lot harder for a great number of people with long standing type2. crazydiamond67 has told us she has had type2 for 15 years and “eat less carbs” is not working for her.

Hence she needs to do detailed research herself reading the books written by the leading experts or find a hcp that has done so. Clearly her GP has not; otherwise she would be posting in the “Success Storeys” section.

Eat less carbs, eat the RIGHT amount of protein and fill in it healthy fats works for many of us. Protein and the type of fats all add to the equation.

 

[Kentoldlady1]

Sorry it was not meant to be a blanket statement, clearly people like me who have had Type2 for a relative short time can get great results just from “eat less carbs” without having to think about types of fat, how much and what types of protein etc.

Also some people, who have had type2 for a long time, also get great results just from “eat less carbs” – but it can be a lot harder for a great number of people with long standing type2. crazydiamond67 has told us she has had type2 for 15 years and “eat less carbs” is not working for her.

Ah, ok. Thanks for that. Yes, I absolutely agree. Knowledge is key. It was the paying for support bit I didnt really agree with. I think that for some people it will really help, but isnt necessary.
I had a look at that companies web site and it certainly looked very good. I am sure that a few months ago I might have joined. But I have done it by myself , although like you I am very close to diagnosis. I might feel differently in a few years and appreciate the help from companies like this.

But I couldn't agree more about the need to read everything.

 

[Kentoldlady1]

Ok. Just wrote a reply and it ended up in the quote box!!! What did I do wrong? Fairly certain I wrote after the quote marks!! Think I have done this before on here!

 

[Ack]

No answers only more questions.