Diabetes, life and all that - personal diary

[pavlosn]

What's that now then?
About 13kg in 3 months?
That's pretty good going!

I think 12kg in 2,5 months but happy enough with that!

 

[douglas99]

I think 12kg in 2,5 months but happy enough with that!

Even better,
congratulations!!

 

[PSS]

@pavlosn

Hey, Pavlovs, well done mate. My weight is also down to 81kg. As you know I was on one metformin 500 mg slow release. I was finding even that a lot.

Spoke to my nurse last week and she wants me to stop taking metformin.

Makes me think, the less you weigh better it is for T2.

So well done mate.

Regards

PSS

 

[pavlosn]

Managed to exploit the fine weather by driving to the nearby village of Ayia Anna for an alfresco lunch with friends and family at a nice traditional taverna.

Did my best to keep it low carb but I did have a small helping of desert. Irrespective of this I am at 5,0 mmol one hour later so no harm done.

Pavlos

 

[pavlosn]

Relieved to see 93mg/dl ( 5,16 mmol) this morning, after going to bed at 120mg/dl (6,66 mmol) last night after a late dinner, which probably included a few too many carbs.

Since Saturday, I am experimenting with a reduced Metformin dosage of 1000mg (2*500mg) per day rather than my usual 1700mg (2*850mg).

To be honest this was not so much a planned decision but rather the spur of the moment response to running out of 850mg meds over the weekend and having an older box of ( fortunately still not past their sell by date) 500mg meds at home from back when I used to take 3*500mg per day.

I felt a bit naughty doing this without my doctor's consent but I decided that as I monitor my glucose quite closely it was a pretty safe experiment to undertake.

Although I do have a spare unused box of 850mg meds at the office, I decided to stick with the 500mg to see how I respond.

So far my glucose levels do not seem to have been adversely affected.

My morning walks have resulted in increased glucose levels in the last two days though where I would normally expect to see drops.

Normally as long as I am above 5,0 mmol on waking up, going on my walks without having anything to eat results in a drop in my sugar levels.

In the last two days, my fasting levels before the walk were 5,5 and 5,1 respectively and after the walk 6,0 and 6,1 respectively - liver damps, where I would normally not expect them.

The only difference I can think of is my experimenting with a reduced Metformin dose of 1000mg daily rather than my normal 1700mg.

A sample of two is probably too small to draw any reliable conclusion though.

I will stick with the lower dose and see how I get on.

I also seem to feel more hungry but wonder if this is just psychosomatic, I am aware that Metformin is supposed to be an appetite suppressant so I may be feeling hungry because I expect to feel hungry!

Pavlos

 

[PSS]

Relieved to see 93mg/dl ( 5,16 mmol) this morning, after going to bed at 120mg/dl (6,66 mmol) last night after a late dinner, which probably included a few too many carbs.

Since Saturday, I am experimenting with a reduced Metformin dosage of 1000mg (2*500mg) per day rather than my usual 1700mg (2*850mg).

To be honest this was not so much a planned decision but rather the spur of the moment response to running out of 850mg meds over the weekend and having an older box of ( fortunately still not past their sell by date) 500mg meds at home from back when I used to take 3*500mg per day.

I felt a bit naughty doing this without my doctor's consent but I decided that as I monitor my glucose quite closely it was a pretty safe experiment to undertake.

Although I do have a spare unused box of 850mg meds at the office, I decided to stick with the 500mg to see how I respond.

So far my glucose levels do not seem to have been adversely affected.

View attachment 8724

My morning walks have resulted in increased glucose levels in the last two days though where I would normally expect to see drops.

Normally as long as I am above 5,0 mmol on waking up, going on my walks without having anything to eat results in a drop in my sugar levels.

In the last two days, my fasting levels before the walk were 5,5 and 5,1 respectively and after the walk 6,0 and 6,1 respectively - liver damps, where I would normally not expect them.

The only difference I can think of is my experimenting with a reduced Metformin dose of 1000mg daily rather than my normal 1700mg.

A sample of two is probably too small to draw any reliable conclusion though.

I will stick with the lower dose and see how I get on.

I also seem to feel more hungry but wonder if this is just psychosomatic, I am aware that Metformin is supposed to be an appetite suppressant so I may be feeling hungry because I expect to feel hungry!

Pavlos

Pavlos

The other thing is Metformin stays in the body for a while and you having reduced the dosage for just two days . It is unlikely to have made a huge difference.

As you yourself say that two days in a too small a sample.

Keep us posted on how you get on with the lower dosage.

Regards

 

[pavlosn]

Pavlos

The other thing is Metformin stays in the body for a while and you having reduced the dosage for just two days . It is unlikely to have made a huge difference.

As you yourself say that two days in a too small a sample.

Keep us posted on how you get on with the lower dosage.

Regards

You are absolutely correct about more time and data being required.

At least testing will be a bit more interesting in the next few days.

My original intention was to go and see my doctor in the New Year and discuss the possibility of reducing then.

Events have worked out differently.

I will call him and book an appointment for next week probably.

Pavlos

 

[pavlosn]

A number of things have conspired to keep me away from my morning walks this week and consequently, as I usually update this diary immediately after, away from this thread as well.

I managed to catch a cold for one thing; fortunately now fully recovered.

I have been on taxi service early in the morning as well, either giving my son a lift to school or taking one or another of my parents to early morning hospital appointments; my dad for his regular examinations and my mom for a final check up before her cataract operation on the 19th.

I have continued with the reduced dose of metformin and despite the midweek cold my glucose levels seem to be holding reasonably well.

The only exception seems to be that I get liver dumps after exercise when normally I would not expect them to happen; metformin is known to reduce glucose release by the liver. I will need to adjust my habits a little bit if I am to continue with the lower dose and have something to eat before exercising.

Saturday mornings are when I have my tennis game/lesson for an hour.

Being an 8:00 am start, to avoid the heat in the summer, I did not to have time to have any breakfast before. And, as is now becoming my habit I rode my bike to and from the club for a bit of extra exercise ( about 8km in total)

And being a truly glorious winter morning (16 degrees centigrade expected to rise to 21 by lunchtime), with blue skies and plenty of sunshine i took a detour on the way back to ride through the grounds of my favorite monastery.

By which time I was hungry, not to mention probably a bit low on glucose, so the ripening citrus fruit in the orchard looked very tempting.

Although I suspect the monks would not mind if I helped myself to one, why would they plant the trees either side of the main path through a publicly accessible park otherwise,

I still could not bring myself to do so without their expressly stated permission. Sometimes I can be sow straight laced, I make myself sick! It was only an orange after all, but it did not feel right to me so..,

The result of all this morning activity. My glucose shot up from 5,3 mmol on waking to 6,8 before breakfast two hours later, without me taking in anything other than water! You've got to love liver dumps!

At least I did win the game of tennis!

Pavlos

 

[douglas99]

That's the point of a liver dump though..
I use mine to my advantage, my morning one certainly, I'm sure I can feel.
If I get up before it happens, I'm in the 5's.
If I don't, (using because I'm still tired, cold, sleepy etc) my body, quite correctly, gives me a nudge, with more energy, and I may be into the high 5's, even 6's.
Even if eat, so long as I don't go higher than 'normal', either way is fine for me.

But you've not eaten, been out for exercise on the bike, played tennis, exercised on the bike again?

Your liver has taken a quick look in your bloodstream, seen your BG plummeting, sworn to itself a bit, and released, quite correctly, some much needed fuel for your muscles, and body.

Maybe the change in meds means it's overcorrected just a touch, maybe it's your meter, but 6.8 is well within the post meal range you could expect to see if you had supplied the energy by food instead, and it's still very close to the 'normal' range of 4.4 to 6.1 you can expect the average body to try to maintain anyway.
(Personally, I'd count it as very normal, if you've just been doing exercise, then stopped, as your body will see a sudden decrease in the amount of energy used, and your liver will have been building up the release for the sustained exercise, so it's bound to overshoot slightly)

Looking good!

 

[pavlosn]

That's the point of a liver dump though..
I use mine to my advantage, my morning one certainly, I'm sure I can feel.
If I get up before it happens, I'm in the 5's.
If I don't, (using because I'm still tired, cold, sleepy etc) my body, quite correctly, gives me a nudge, with more energy, and I may be into the high 5's, even 6's.
Even if eat, so long as I don't go higher than 'normal', either way is fine for me.

But you've not eaten, been out for exercise on the bike, played tennis, exercised on the bike again?

Your liver has taken a quick look in your bloodstream, seen your BG plummeting, sworn to itself a bit, and released, quite correctly, some much needed fuel for your muscles, and body.

Maybe the change in meds means it's overcorrected just a touch, maybe it's your meter, but 6.8 is well within the post meal range you could expect to see if you had supplied the energy by food instead, and it's still very close to the 'normal' range of 4.4 to 6.1 you can expect the average body to try to maintain anyway.
(Personally, I'd count it as very normal, if you've just been doing exercise, then stopped, as your body will see a sudden decrease in the amount of energy used, and your liver will have been building up the release for the sustained exercise, so it's bound to overshoot slightly)

Looking good!

Thanks Douglas

The problem was that I ended up at 6,8 mmol and hungry and needing to have breakfast.

I did have some bacon and eggs.

I did not have the opportunity to test at two hours but, just before lunch, just under three hours from breakfast I am at at 5,7, which is more or less normal for me.

So all's well ...,,

 

[Bluetit1802]

Pavlos, I don't understand why you continue your overnight fast until after your morning exercise. Is there a particular reason for this? Surely it might be better to eat first, then use the exercise to burn off any carbs?

 

[douglas99]

that sounds normal as well though. Don't forget, all your liver does in try to keep your BG up, without overshooting. When you eat, it'll stop, and actually start to replace the stores its used, so in a correctly operating system, it'll be pulling your numbers down again.

 

[pavlosn]

Pavlos, I don't understand why you continue your overnight fast until after your morning exercise. Is there a particular reason for this? Surely it might be better to eat first, then use the exercise to burn off any carbs?

@Bluetit1802

I guess force of habit and convenience. I grew up always being told that one should not exercise on a full stomach.

It also fits in with my morning routine better. I wake up, go on my walk and then when I return all weary, shower and get dressed while my breakfast is prepared. Have breakfast and then go to work.

Specifically today the reason I did not have something is because I was too late getting up and had to rush off to the tennis club if I was to make it there in time for my game.

I don't need to have a full breakfast to stop the dump. A small piece of fruit is usually sufficient.

Before I cut the metformin down I could more or less manage to avoid dumps by following the following rule of thumb: if fasting level on waking up was 5 or over I would be safe to go on a walk as I was, while if under 5 I would have a small snack such as as a piece of fruit to make sure that my levels do not trigger a dump.

I love fruit anyway and this was a guilt free way to incise in my diet.

My post prandial levels after breakfast have been good so I did not need to exercise to bring them round further.

As I said I need to experiment to settle on a new routine.

Pavlos

 

[douglas99]

Give it a while for the decrease in meds to settle through.

Although, do bear in mind a liver dump is normal, and you are getting normal figures from them.

I would say, it's when you are more insulin resistant that they are a problem.
You need energy, your liver dumps into your blood, raising your BG.
Your pancreas releases insulin, now in a 'normal' response, the insulin enables your body to use the BG, and the body releases an enzyme to tell the liver to stop.
If you are insulin resistant, your body doesn't use the BG, and keeps telling the liver to dump, so your BG rises past normal levels.

So, you can avoid the 'dump' by not getting to the stage where you go lower than your body likes in the first place, but I would suggest, like me, you probably have decreased your insulin resistance sufficiently for that not to be a major problem anymore, as you don't seem to be overshooting.

After that though, you then have to consider you are now eating starting at 6.8, rather than 5.3.
So, a combination of what you eat, how much you eat, how fast you digest it, your livers response as it too tries to recharge, your insulin resistance now, and your own personal ceiling for BG come into play.
Only way to find that out is to test, maybe the timescale was over long, but apart from that, 5.7 later sounds fine.

 

[pavlosn]

@douglas99 @Bluetit1802

Never a dull moment living with diabetes!

I suppose it's the part of us which wants to chase improvement rather than saying this is good enough.

I decided to experiment with reducing my metformin so of course some of my previous routines will have to change and of course I will have to give it all more than a few days to settle.

As you kindly point out, what I have experienced is the normal protective mechanism of the liver working as it should.

I have not really lost control of my levels so onwards we go!

Thanks you both for your interest and time.

Pavlos

 

[pavlosn]

Following on from yesterday's discussion on the subject of liver dumps, I decided to try something different today.

Being a Sunday and so having more time available in my hands, I can afford to be more flexible with my morning routine. I decided therefore to follow @Bluetit1802 's suggestion and have my breakfast before exercising.

I woke up really early today at about 4:30 am, it was pitch black and eerily quiet, tested and my fasting glucose was 5,3 mmol. A fairly representative number for me.

Be 7:30 when I had my breakfast this had gone up slightly to 5,7 mmol.

One hour after breakfast of two eggs, two rashers of bacon and some herbal tea, I tested 5,7 again and set out on my morning walk.

At 9,30 having completed a 6km walk I tested at 5,5 mmol.

Perhaps it may have been more useful if I had more carbs for breakfast.

As it is, I had a series of four count all in the 5s so I have to be pleased about that.

As usual, my walk provided some nice floral photo opportunities.

Not sure what the top flower is, a clerodendrum if forced to offer a guess, but the bottom one is a passion fruit flower: passiflora something-or-other.

On returning I found that a neighborhood dog had come to pay his amorous attentions to Sheelba.

They look cute together and I am sure any puppies would be even cuter, but I do not want to find out, so that tall gate remained firmly closed.

Pavlos

 

[Mike d]

What's Greek for "sit" Want a dingo to sort 'em out ? On second thought, maybe not

 

[alliebee]

By luchtime there will probably be a group of amourous dogs

 

[pavlosn]

By luchtime there will probably be a group of amourous dogs

I will not be there so it will not be my problem ( for now at least)!

 

[Jamrox]

Hi Pavlos , I see your point about fruit . I love fruit.
I find that oranges , bananas and apples make my bs rise high.
I tend to stick to berries and find they re ok .

Since I lost 2stone and like you active most days I find that if
I eat low carb during the day then I can have a potato or small portion of rice /pasta and lots of sauce for my evening meal.
I can eat a little bit ( I stress the little ) of sugary stuff like dark chocolate .
I'm still diet controlled and don't push it , obviously if I over do it I suffer so it's not worth it .