High BS - Not reducing quick enough!

[SRO]

Hi all,

Was diagnosed about a year ago with Type 2. Didn't change anything and my HBA1C went from an initial reading of 99 to 116 a couple of months ago.

I was on Metformin 2 x 500's from the end of August, but increased to 2 x 850's about 3 weeks ago.
My bloods are consistently high. The lowest readings I've had are 13's, but I'm always around the 15/16 range.

The pills don't seem to be doing anything (I know not to expect a miracle, but out the danger zone would be great).
I'm now testing around 4-6 times a day to see what effect things are having - my morning readings now always seem to be the highest.
I even tried changing the timings of taking my medication, but nothing changed.

I've changed my diet significantly over the past 2 weeks so now <60g of carbs during the week, and around 100g at the weekend (less if possible).

Does anyone have any suggestions to speed this up a bit before I do any more damage?

I'd like to try 3 x 850's a day of Metformin - could this be a start??

Thanks for the help.

 

[novorapidboi26]

quite simply more medication............

insulin.........

activity should help as well.......which is hard when your in the double figures, I know...

have a chat with the doctor..........

 

[Robbity]

As a type 2: basically watch your carbs! Your metformin is not going to fix things - it will only help a little - it's generally a serious reduction in high starch and sugary carbs that will make the biggest difference for you, as these are what raise your glucose levels. If you test immediately before, and 2 hours after starting to eat, your meter should be telling you which foods are giving you the biggest spikes, and the best thing to do is avoid these completely or at least reduce your portion size drastically for these. These mealtime figures are probably the most important ones for you at the moment - worry about your early morning levels later. See http://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html for recommended levels and aim for spikes of under 2mmol/L after your meals.

If you tell us what you're eating then we can maybe help sort out your diet.

Robbity

PS If you want to change metformin quantities you need to ask your doctor. As I understand it though, there's a maximum ceiling after which you apparently don't get further benefits from increasing doses.

 

[SRO]

Thanks very much.

Normal breakfast would be a couple of boiled eggs and some Fridge Raiders chicken (bag of 100g).
Mid morning snack is usually some strawberry protein sweets (3.5g carbs per pack)
Normal lunches would be Lidl high protein bread (Doesn't spike me) with a couple of boiled eggs and a couple of cheesestrings.
Dinners vary much more, but I use the "eat water" zero carb spaghetti with either Bolognese, meatballs, etc.
If I have a take away (once a week, maybe), I have chicken curry (no rice), and soup.
I may also have a late night snack of another lidl bread with peanut butter.

There's obviously some coming and going, but I don't eat potatoes, rice, chips or normal pasta.

At the weekend, I may have a starbucks with full milk and a muffin (54g) - so I am counting.

I'm a big eater, so it's a huge change, but not horrific.

I really don't want to move on to insulin, but I'm getting the fear that it's heading that way after the last chat with my DN.

 

[Brunneria]

Have you heard of insulin resistance? It is very common (maybe universal) amongst T2s

It is where our body produces insulin, but the muscle and fat cells are resistant, so it can't do the job properly.
You reduce insulin production (and in time, IR) in a number of ways, with reducing carbs in the diet as being the biggest and best.

Then comes weight loss and exercise.
- losing weight means that there is less fatty tissue that needs to be flooded with insulin. So it goes further, and works better
- exercise can REALLY help too. It doesn't have to be violent, or an endurance test, but it should use your major muscles until they warm up. You can walk, climb stairs, take an exercise class, go for a run or sit in a chair and wave around tins of soup as improvised dumbells... the main thing to do is to get your muscles warm and active. The result should be that the muscles themselves get a better blood supply, and are able to make better use of the insulin, and the blood glucose that are circulating. Depnding on your starting fitness level, you may need to see a doc, or start off very very slowly, but the important things are regularity, consistency, and choosing something that you enjoy.

There are some otherways to reduce IR too:
- metformin helps. it actually works better as a way to reduce IR than it does to lower blood glucose
- checking any other medication you are on. I am on a med that raises IR. Sadly, I need it, and can't do without it. But some people can find alternatives,

Hope that helps.

 

[Totto]

Hi @SRO you could try and reduce carbs further. Have you seen the http://www.dietdoctor.com/lchf site? I follow his advice and keep BG normal. Proper food, no processed stuff and no starch.

 

[DeejayR]

Small thought ... seems to be a lot of protein in the food you mention above, and hardly any fresh veg. I also eat a lot and probably too much protein, but I also pile on the steamed greens, celeriac, some butternut squash, leeks, onions, and of course the faithful cauliflower in various guises.

 

[ButtterflyLady]

Something like 50% of protein is converted to carbs in the body, so you may want to replace some of your high protein foods with higher fat foods, and veges. If I was in your shoes I would give the muffins and milky hot drink a miss too. There are low carb baked goods you can make at home if you want. Black coffee is fine, maybe with cream as it is much lower in carbs than milk. I aim for about 50g of carbs a day. Check the carbs in the soup too.

Ask your doctor about increasing the metformin - the max dose of slow release is 2000mg a day and immediate release is 3000mg a day.

 

[SRO]

Thanks all.

I didn't really take my diet serious for the first 10 months so it's my own fault that I'm in this position, but I was losing a lot of weight which I was unable to do before.

I'm a proper fatty at heart and love eating, so it's a huge change that I'm really trying to deal with. It's more about quantity of food with me than quality.
I'm 10 stone down, and a "normal" weight now - so allowing myself a muffin at the weekend but keeping on a decent path the rest of the time might be worth it.
Cutting out the "treat" might make me binge, which I don't want to do!

I did read that hot and sour soup was a better choice than some of the others, and again, I'm counting what I'm eating.

@Brunneria Thanks so much for that - I wasn't aware, and that's really interesting to know. I'm keen to try an extra metformin (mainly for my own peace of mind that I'm getting some help as well as trying to help myself). Got the dr calling this afternoon, and he's been pretty good so far.

@CatLadyNZ It's so conflicting about cutting carbs but now eating too much protein (if that is the case). How do I know how much is too much.
I eat more eggs than I should and have been reading so much information about whether they're good or bad for T2.

@DeejayR Cheers - I do eat salad with dinner, but maybe not as much as I should. I can try and incorporate this in place of something else bad.

@Totto Cheers - I'll take a look at this later. Thanks for the link.

 

[ButtterflyLady]

Thanks all.

I didn't really take my diet serious for the first 10 months so it's my own fault that I'm in this position, but I was losing a lot of weight which I was unable to do before.

I'm a proper fatty at heart and love eating, so it's a huge change that I'm really trying to deal with. It's more about quantity of food with me than quality.
I'm 10 stone down, and a "normal" weight now - so allowing myself a muffin at the weekend but keeping on a decent path the rest of the time might be worth it.
Cutting out the "treat" might make me binge, which I don't want to do!

I did read that hot and sour soup was a better choice than some of the others, and again, I'm counting what I'm eating.

@Brunneria Thanks so much for that - I wasn't aware, and that's really interesting to know. I'm keen to try an extra metformin (mainly for my own peace of mind that I'm getting some help as well as trying to help myself). Got the dr calling this afternoon, and he's been pretty good so far.

@CatLadyNZ It's so conflicting about cutting carbs but now eating too much protein (if that is the case). How do I know how much is too much.
I eat more eggs than I should and have been reading so much information about whether they're good or bad for T2.

@DeejayR Cheers - I do eat salad with dinner, but maybe not as much as I should. I can try and incorporate this in place of something else bad.

@Totto Cheers - I'll take a look at this later. Thanks for the link.

I think eggs are fine. I've figured out an eating plan that works for me but I wasn't too precise about how much carb, protein and fat there is... others here are much better at answering the question of "how do I know how much is too much". They use apps, books and all kinds of methods to arrive at target amounts. @GeoffersTaylor has a good method.

It'a awesome that you have lost 10 stone and gotten into the normal weight range, it really is. I think what's needed now is some tweaking to get your BGs down too.

If you find you're unable to do this through low carbing, there is a range of meds that may also help, all with their own benefits, side effects and risks. If I were you, I would want to get my BGs into the target range within 3 months.

 

[SRO]

I have read so much information on the medications available, and they're all a bit bloody scary!
I'm happy with metformin just now as I don't have any side effects (anymore) - the first couple of weeks were horrific!
If they're not doing anything for my BS levels, though, I'll need to cut carbs further to do it by diet.

I'm going to look at the diet doctor and see what more information I can use for my needs.

I'm so thankful this forum is here - despite the fear of asking a ridiculous question that might seem so obvious to someone else, it's so helpful!
So thanks!

 

[GeoffersTaylor]

Hi
The method I use for my LCHF regime is this (and I claim no credit for it - I read it somewhere else) ...

Note that carbs and protein have 4 calories per gramme. Fat has 9 calories per gramme, so it's about TWICE as calorific as the other two.

1) - Use an online calculator to decide what your base calorie intake should be. There are a few methods - try Googling for "Harris-Benedict equation". In round figures, my total came out at 2000 calories per day. I'm still currently looking to lose weight so I aim for just 1500 calories.
2) Set a carb limit. I aim for 30g. 30g x 4 = 120 calories.
3) Protein should be about 1 - 1.5 grammes per KG of bodyweight. I'm now just under 65KG, so that works out for me about 100g of protein per day. 100g x 4 = 400 calories.
4) So, now my protein & carbs are giving me 520 calories. That means I need 980 calories from Fat to make up my 1500 total. At 9 calories per gramme that gives 980 / 9 = 109 grammes.

That is then 30g carbs, 100g protein, 109g fats. Of course life isn't that exact so I just say that fat and protein are about equal.

So, for me, if I eat roughly the same weight of protein and fat I get pretty much the right calorie mix.

Note that the protein calculation should really use LEAN bodyweight, so if you are a long way overweight you should user the lower end of the 1 - 1.5g range. If you're into hard weight training you might want to eat 2g per KG to build muscle, or even more if you're planning to become like Schwarzenegger!

Hope this helps

 

[SRO]

@GeoffersTaylor Thanks very much - that's a lot of information that is definitely worth trying.
Can you just double check:
14st (89kg) - Aiming for 50g carbs/daily.

So:
50g / 200kcals of carbs.
134g / 536kcals of protein.
185g / 1665 kcals of fat

If you don't mind me asking, what kind of things do you eat to stick to your ratio?
How long have you been working to this method?

I've also just spoken to my dr, and my metformin is increasing from 2 x 850mg, to 2 x 1000mg, so hopefully this will help as well!

 

[GeoffersTaylor]

In the low carb section of the forum there's a thread called "What have you eaten today?". Quite a few of us LCHF peeps regularly post our meals there, so it's worth a view.

I don't know what your calorie target is, but your grammes to calories calculations look OK to me.

 

[JenniferW]

I was diagnosed T2 in May, and started to make big changes to my diet in July when I found out about meters and low carb diets. Much to my surprise, i didn't get quick results. I couldn't see what I was doing wrong. But I hung on in there and focused on reducing the carbs and increasing the exercise, and am getting results. But my daily average is between 50 and 100 g / carbs. If it were lower, I'm sure I'd get more improvement, but I'm going slowly and with lots of thought because I've got a history of eating issues and I'm trying to develop new habits that I'll be able to live with for the rest of my life.

Can I say I also thought you were really short on vegetables? I aim for a minimum of 5 portions a day, and focus on all the low carb ones, and it's great for having meals which seem a reasonable size - and for more variety!

 

[artygeorge]

HI SRO................i was on 4x 500 mg of metformin a day plus glicazide, sitlagliptin etc etc, for nearly 4 years. But my blood sugars were exactly like yours. March this year started on insulin(novarapid&levimir). Readings were a little better, but not brilliant. My local diabetes team were a great support as i became increasingly frustrated. Long story short, i used to love bread. Cut it nearly completely out of my diet,results readings of between 5 and 8. Also told by dietician to cut down on fruit intake and try to do a nice steady walk everyday. I was like you a bit dubious about going on insulin, but trust me it is a natural product which unfortunately your body cannot produce enough of. You have to be very disciplined in taking all medication,times and dosage, but the main point is really cut back on carbs and trust me the results will follow. Try not to get too hung up on the numerous healthy diabetic eating regimes,just concentrate on getting your balance right. My quality of life has improved 10 fold. All the best keep going you will get there.