Hyperglycemic advise sought

[jode72]

Hi Guys

Just wondered at what point do you seek medical advice when BG is high ??? I know how to watch and treat Hypo (had a few) but nowadays i always seem to be Hyper, Diabetes nurse didn't seem to worry and told me to only test 3 times a week at most, so went and saw the GP as I was feeling pretty bad who bought forward my HBAc test and oh yeah your too high !! now increasing my gliclazide from 2 x 80mg a day to 4 and think I am on maximum dose of Metformin (2000mg a day) so if that doesn't work what happens next is there another medication I will be given??. and as my BG creeps (well more jumps) up through the day regardless of a careful diet, and having to test over the next few weeks 3 to 6 times a day to make sure all is well.

Just begged the question of how high is too high and needs medical intervention or does high BG not require medical help ???

appreciate any advise

Jo

 

[pavlosn]

My guess on what would be too high would be anything in the 20s - but this is just a guess.

I suppose if oral medication no longer helps what follows is insulin.

You say that your level jumps during the day. Is there a recognizable pattern to these jumps or spikes. How high are they and how long do they last? If they coincide with meals then maybe you need to reduce the carb content of these meals.

Many on this forum have found success using a low carb high fat diet. You could try this and see if it works for you.

 

[jode72]

Hi Pavlosn

today for instance 14.7 before breakfast (ate last night at 630pm tested at 830am this morning) 14.5 2 hrs after (had porridge no sugar made with soya milk) 2 hrs after lunch (1 small wholemeal roll and some parsnip soup) 16.3 would try the low carb high fat but I have no gallbladder so can't process high fat makes me pretty ill !!

Jo

 

[Daibell]

Hi. Anything over 20 is in the high region and needs attention. Are you normal or overweight? With low-carbing you can increase the protein rather than fat and obviously have plenty of non-root veg. I went thru max Metformin then max Gliclazide added. Sitagliptin was also added and helped me for a while before insulin. I have never been overweight so my problem was lack of insulin production i.e. LADA. I can't quite understand why you are moving between hypo and hyper? Normally only Gliclazide causes hypos and that only happens if your pancreas can still produce insulin. What was your last HBa1c?

 

[jode72]

last HBA1C was 8.5 whatever that means !!! I am average size 14 could probably lose a few pounds but nothing serious love my veg and do try to limit carbs

 

[pavlosn]

Hi again @jode72

It does not sound as if going low carb high fat is a sensible suggestion in your case if high fat makes you ill.

You should also be wary of going high protein as that is said to be dangerous to the kidneys particularly where the kidneys have already suffered some damage.

As for HbA1c, it is not great but it could be a lot worse I guess. Diabetics are usually asked to be under 6,5% or 7,5% if thought to be at risk of hypoglycemia.

As you can see from the following table 8,5% corresponds to an average glucose level of almost 11 mmol or 198mg/dl. Within that average there are bound to be peaks which are considerably higher.

You can read more about HbA1c here:

http://www.diabetes.co.uk/what-is-hba1c.html

Please note that reducing your HbA1c by 1% to 7,5% would reduce your risk of some diabetic complications by as much as 25%.

I regret that I can not make specific dietary recommendations to you as I am not familiar with your particular circumstances i.e the absence of a gallbladder. My advice is that if you do decide to experiment with your diet you at least keep your doctor informed to monitor your progress/ any known risks.

Increasing your physical activity ( more walking for instance) and shedding any excess pounds should certainly help with the glucose control.

Even if you do end up on insulin, and this is something that only your doctor can decide, this may be not such a bad thing. I have read many posts on this forum from diabetics who were relieved to finally be able to get unruly glucose levels under control by starting on insulin.

All the best

Pavlos