Advice needed please -Sugar Readings

[Rach123]

Hello everyone

I'm very concerned about my mums sugar levels. She is type 2 diabetic and recently discharged from hospital after being treated for pneumonia and suspected clot (PE). Doctors have now suggested mild heart failure.

Mum is 71, her medications include atorvastatin, aspirin, beta blocker, furosemide, levothyroxine, vitamin D, and depression meds.

Upon admission to hospital (8.8.14)her sugars were 21, I believe this was from a fingerprick test. Her last out patient blood test (22.8.14) come back with a sugar reading of 92.

I am very confused with these readings. GP and pharmacist have informed me that 92 is very high and she now has been prescribed with striptagliptin, not sure about spelling sorry. This is in addition to taking maximum dose gliclazide. I understand high sugar levels over a period of time are damaging to the organs and circulation. Mum is experiencing some pain around her liver area. She is now waiting a liver scan and more blood tests for liver and kidney function.

Previous blood tests showed liver and kidney function was out of the recommended range and mums sugar levels have apparently been high for the last 4 months. Until her sugar levels stabilises, I am worried sick that these high sugar levels are causing further damage to my mums health.

I would very much appreciate advice/any kind of reassurance.
Many thanks
Rach123

 

[sanguine]

Hi Rach

Sorry to hear about your Mum, but you've come to the right place for help and support.

Firstly, it looks to me like the 92 figure is an HbA1c result in mmol/mol, roughly equivalent to a fingerprick result of 14 mmol/l. That is high but can be managed down. The fingerprick test of 21 is also high but may be adversely impacted by the pneumonia, possibly by your mum's meds and the stress of admission.

HbA1c is a measure of 'average' blood sugars over a 2 month period or so, whereas the fingerprick test is just a snapshot.

Can I ask what your mum's diet is? Blood sugars can be reduced by reducing intake of carbohydrates, especially bread, rice, potatoes and pasta, as well as the obvious sugars.

I'm sure there will be others along who can give more advice.

 

[Rach123]

Hello sanguine,

thank you so much for replying so promptly with your explanation. My mum does not follow any kind of diabetes specific diet plan. Out of the examples you provided me with, she eats bread and potatoes regularly (white - daily/every other day) she eats meat ( including processed) every day and probably more than once daily which she insists on frying.

She also still consumes cakes, believe it or not. Her activity level is ridiculously low....... I suppose it's all so obvious. However since this latest scare, she has not been consuming processed meats, cakes etc. still her sugar rose from 80 last June - 92 august 2014. I don't understand this increase when she is consuming less than normal.

Kind regards
Rach 123

 

[Munchington]

Hello everyone

I'm very concerned about my mums sugar levels. She is type 2 diabetic and recently discharged from hospital after being treated for pneumonia and suspected clot (PE). Doctors have now suggested mild heart failure.

Mum is 71, her medications include atorvastatin, aspirin, beta blocker, furosemide, levothyroxine, vitamin D, and depression meds.

Upon admission to hospital (8.8.14)her sugars were 21, I believe this was from a fingerprick test. Her last out patient blood test (22.8.14) come back with a sugar reading of 92.

I am very confused with these readings. GP and pharmacist have informed me that 92 is very high and she now has been prescribed with striptagliptin, not sure about spelling sorry. This is in addition to taking maximum dose gliclazide. I understand high sugar levels over a period of time are damaging to the organs and circulation. Mum is experiencing some pain around her liver area. She is now waiting a liver scan and more blood tests for liver and kidney function.

Previous blood tests showed liver and kidney function was out of the recommended range and mums sugar levels have apparently been high for the last 4 months. Until her sugar levels stabilises, I am worried sick that these high sugar levels are causing further damage to my mums health.

I would very much appreciate advice/any kind of reassurance.
Many thanks
Rach123

Hi
Again, sorry to hear about your mum.
Diabetes is a very misunderstood condition...I was totally ignorant to it all until my 2yr went into a diabetic coma.

5yrs on and she is doing really well but the key for us has been carb counting.
She is type 1 and her pancreas has now completely failed in producing insulin (which is actually easier to keep control!)

But I implore you to learn how to count your mums carbs...it's never too late to learn!
My daughter eats bread, cakes and even sweets...nothing is banned, but carbs are carefully counted and insulin is injected accordingly.

Her HbA1C varies between 55-59 which shocks people when they know how much she loves cake!
It won't take you long to lower your mums BG levels if you carb count and she will feel so much better for being more stable.

I am not sure how T2 diabetes works in relation to taking insulin however if your mum can be aware of the carbs in her food it may help her to understand his to start to reduce her BG levels without missing out on her favourite treats.

Good luck...if my 7yr old can do it, I'm sure you will find a way to help your mum become aware!

Kind regards

 

[sanguine]

Rach

It's good that she has cut out the cakes, but no real harm in eating processed meats - although 'real' meat is probably better.

I would guess it's the bread and potatoes that are causing the biggest problem. Carbohydrates metabolise to sugar very quickly so for a diabetic it might as well be sugar. This will be contrary to standard NHS diet advice which is wrong for diabetics. Many T2s control their condition by restricting foods to those containing less than 10g per 100g total carbohydrate (ignore the 'of which sugar' bit on the labels, that's not relevant to us). Or even less than that. Watch out for low-fat options, they often contain added sugar.

Another possible problem area is fruit. It's best to avoid sugary fruits and 'natural' fruit juices, especially those from tropical fruits such as bananas. Grapes are also high in sugar. Apples and pears may be OK in moderation, but the best fruit for a diabetic is berries - strawberries, raspberries, blackberries, blueberries.

Hope this helps. Ask any other questions you want.

 

[sanguine]

I am not sure how T2 diabetes works in relation to taking insulin however if your mum can be aware of the carbs in her food it may help her to understand his to start to reduce her BG levels

Rach, you don't mention any meds your mum is on for the T2? Is she on metformin or something else? T2s don't normally have to go onto insulin unless the condition is severe and out of control. Diet management is the best 'medication'.

 

[Brunneria]

Hi Rach, you've had some good advice so far.

Basically, the thing to remember is that (despite conventional wisdom), there isn't much difference between eating sugar, cake, bread (white or brown), rice, breakfast cereal, pasta or potatoes - or fruit!.

They all quickly turn to sugar in the blood.

The bigger the portion, the larger the rise in blood sugar.

So if your mum has swapped cakes for toast, or biscuits for fruit, or stopped eating pud, and increased her potatoes instead, then her blood sugar may not have improved, or may even have got worse.

There are LOTS of foods that don't raise blood sugar, including all meat, fish, eggs, cheese, all veg (except root vegetables like potato, parsnip). Most of us find that berries like strawberries, raspberries, blueberries and cherries, are great, while bananas and other sweet and tropical fruit may cause problems.

The good news is that there are a lot of great foods that don't drive bloodsugar up too high.

 

[Rach123]

Thank you so much to you all for your advice, you have really helped. I am actually beginning to feel a little less stressed, upset and overwhelmed.

Right, that's it carbs will now be monitored as of now. I will follow your advice and ensure my mum starts to understand. however, at the moment, my mum is depressed so it will be quite a while before she gets a handle on things. I have already advised mum not to have any natural fruit juices for the time being.

My mum's diabetes medication is maximum dose Gliclazide and the newly prescribed Striptagliptin (not sure on the spelling). The pharmacist told me it could take approx a week and a half for this medication to start to lower sugar level. Hopefully now with the immediate change to diet and increased medication her sugars should reduce. The plan is to convince my mum to become more active(which I have tried for years believe me) and obviously follow a diabetes friendly diet. Consequently, this might mean in time that her medication will be reduced.
Does anyone know if I can download an actual diet plan for her to follow?

Many, many thanks again

Rach

 

[Brunneria]

Thank you so much to you all for your advice, you have really helped. I am actually beginning to feel a little less stressed, upset and overwhelmed.

Right, that's it carbs will now be monitored as of now. I will follow your advice and ensure my mum starts to understand. however, at the moment, my mum is depressed so it will be quite a while before she gets a handle on things. I have already advised mum not to have any natural fruit juices for the time being.

My mum's diabetes medication is maximum dose Gliclazide and the newly prescribed Striptagliptin (not sure on the spelling). The pharmacist told me it could take approx a week and a half for this medication to start to lower sugar level. Hopefully now with the immediate change to diet and increased medication her sugars should reduce. The plan is to convince my mum to become more active(which I have tried for years believe me) and obviously follow a diabetes friendly diet. Consequently, this might mean in time that her medication will be reduced.
Does anyone know if I can download an actual diet plan for her to follow?

Many, many thanks again

Rach

The depression, lack of energy and general disinterest in life goes hand in hand with high blood sugars, I'm afraid.

I can remember the surprise I felt when I got my blood glucose down, and I actually had enough energy to last the day! It seemed incredible to me. I had got so used to bracing myself before having to walk anywhere, or sustain any kind of activity. It was like getting my life back.

But one word of caution - if someone's blood glucose has been high for a while, it is kinder to change things slowly, rather than all at once. Kinder on the body, I mean.

Maybe cut carbohydrate portions over several days, down to half quantities? Or cut carbs from one meal at a time, only making a change every few days.

Regarding a diet plan, there are a few out there - Atkins Diet is a classic. You can also find masses of info in the links in my signature - but a lot of that is pretty extreme. I'm guessing that your mum may feel happier with a more gradual transition.

Good luck.

 

[Rach123]

Yes you are absolutely right. A gradual reduction in carbs is far more suitable for my mum. It starts from today!
I am encouraging her to move more around the house as opposed to sitting the whole day and then sleeping the whole night. My mums physical strength and functional ability is affected due to her inactive lifestyle. A gradual lifestyle change may well influence her long standing battle with depression. It's a long process, but fingers crossed everything will improve for her.

Thank you for your time and advice, much appreciated

 

[sanguine]

Here's a good book for a guide to carb, calorie and fat content of a whole load of foods and meals, set against photos of different portions.

http://www.amazon.co.uk/Carbs-Cals-...qid=1409403963&sr=8-1&keywords=carbs+and+cals

 

[Rach123]

Thanks very much, I will look into this