Newbie terrified

[Prince4]

Hi this is a truly great forum to join and I AM Hoping someone can help.

I am T2 SINCE around 18 months ago. I stupidly did not take it seriously enough and my HBA1C went from 56 NMOL - 64 - 56 and then went to a whopping 94NMOL over last xmas. I have started Metformin since February ( 500Mg) and last reading was done to 71 a couple of weeks . Since April I have aggressively started to work out again, running around 25 miles a week and doing 15k steps a day, radically overhauled my diet and am almost certain my next HBA1C will return to the 50's, my other biomarkers have come down radically along with BP and. producing better VO2 max and runs in the gym. I have lost around 25 pounds since February but still around 17 stone.I know that this is still high but I am now losing around 4 pounds a week.

My concerns;

As I am cutting Carbs, I only having 2 meals a day i.e Porridge and fresh blueberries in the morning and fish and Green veggies for dinner ( my carbs have come down significantly) I had my first couple of night hypos given my lips went numb and HR went up , and it was terrifying. I had some mint sweets and an apple and was all ok after 15 mins or so .
Can anyone please give advice around how to avoid this? I was told that carb elimination is the crux of remission but clearly I am eating too little? I am almost tempted to have another bowl of oatmell late in the evening ( I don't tend to eat after 6 pm) so I don't hypo in middle of night?

I have a Aqu- check monitor- is there any advice on when and how to take readings to establish a baseline?

Thanks. in advance

 

[jjraak]

A few things spring to mind.

You seem to be training rather hard, but not eating enough to help sustain it, imho.

I know it can be hard to see the wood for the trees, but with my own loss of weight, (17st -13st) I was probably eating as much as pre DX, but at (post DX) 2 sittings.
Breakfast & one evening meal.

So QUANTITY of food seemed to defy the norm of less equals more weight loss, if that makes sense.

Your own weight loss, at a quoted 4lbs a week, is around a stone each month .perhaps a little too much, but an impressive feat.

And the food would be a concern for me

Porridge, oatmeal ..not things I could eat without spiking.

Once I got over the bs* of how I should eat to be more healthy.
( Eatwell & die - t.)

I rarely went hungry, got HBA1c back to 40 from 58 & lost weight.

More importantly I got all my lipids down to normal or optimal, particularly my trigs.(6 to 1.2)

The secret for me ?

Back to basics.
No prepackaged food
No ready meals.

Meat that looks like meat
Veg that looks like veg.

Cooked by me, with spices herbs as required.

Good luck finding your own pathway.

 

[nutribolt]

I agree with @jjraak and would just add one more suggestion. If its possible and affordable, invest in Freestyle Libre so you can see trends for your blood glucose levels against food you eat and after training. It will help you make informed choices and HbA1c results will also be less of a surprise.

 

[bitofagit]

I am 72yrs old, 6'3'', (firmly believe this has to be taken into account) weighed 17st 7lbs (c. 111kgs) and had bloods review of 60 on 10 May. I had been told prediabetic in 2008 (possibly 2007) and like you did not take a serious look at it. This time told to sort myself out (my expression).
Bit of slap in face and therefore committed to diet overhaul.
Whilst I have now taken this whole T2 thing rather more to heart, I try not to worry too much.
Ditched all sugar from coffee (that was hard), ditched beer entirely (surprisingly not as hard as no sugar in coffee), restrict eating to between 10am - 6pm.
Bread almost completely banished, as are croissants (nearly in tears now) and crumpets.
All meals prepared fresh, nothing packaged.
I test first thing in morning, before and 2hrs after both meals - I found the testing to be a bit compulsive and feel sure it has enabled me to maintain a firmer grip on eating, a favorite passtime.
I have started to exercise more than I have.
As a result of this now weigh 15st 13lb (c.101kgs) and seem to have smoothed out the b.g. counts.

Is your exercise regime a bit on the heavy side when you consider your food and type of food intake?
Is your weight loss a bit too quick?

I understand your desire to remedy your situation, but is that going to be at a cost that could be avoided?

 

[Rachox]

I had my first couple of night hypos given my lips went numb and HR went up , and it was terrifying. I had some mint sweets and an apple and was all ok after 15 mins or so .

It is very unlikely to be getting hypos on Metformin, did you actually test your blood sugar at the time you felt unwell?

 

[Prince4]

It is very unlikely to be getting hypos on Metformin, did you actually test your blood sugar at the time you felt unwell?

I didn’t. I will do this next Time. Thanks.

 

[Liam E]

I have a Aqu- check monitor- is there any advice on when and how to take readings to establish a baseline?

First thing in the morning, before eating, 2 hours after eating are the three numbers of interest for type 2s.

First thing in the morning will tell you how you are getting on, before and after meals will tell you how much that meal raised blood sugar. You want to see the +2hrs being less than 2 above the pre meal level and you want all measurements to be less than 7.

Consider getting a libre2 or similar.

Given your numbers it is likely that you need to be ruthless cutting carbs. The porridge has to go. Meat eggs fish diary and low carb veg should be the bulk (or indeed entirety) of your diet.

For me my glycemic control returned quickly and before any significant weight loss. The weight loss followed controlling blood sugar. You might be putting the cart before the horse trying to control blood sugar by losing weight.

I think perhaps you should consider easing off on the cardio, adding in more resistance exercise and upping the meat / fat intake to slow the weight loss and protect your muscle mass which is important for long term blood sugar control.

 

[ianf0ster]

.... You want to see the +2hrs being less than 2 above the pre meal level and you want all measurements to be less than 7.......

@Prince4 I strongly disagree with @Liam E about having all measurements less than 7 mmol. I have been in low carb controlled T2 D remission for 3yrs and I normally get more than 7.0 mmol at the 2hrs after eating measurement. I still even get some Fasting readings (morning - so includes Dawn Phenomenon) of over 7.0 mmol.
The figure to aim for is to get all (or almost all) readings below or at 8.0mmol, some even say 8.5.

It is hugely important not to push too hard for the lowest possible numbers because this new way of eating needs to be enjoyable or else you won't be able to keep it up over the many healthy years you have ahead of you. Controlling any/all forms of diabetes is a marathon, not a sprint!

 

[Liam E]

@Prince4 I strongly disagree with @Liam E about having all measurements less than 7 mmol. I have been in low carb controlled T2 D remission for 3yrs and I normally get more than 7.0 mmol at the 2hrs after eating measurement. I still even get some Fasting readings (morning - so includes Dawn Phenomenon) of over 7.0 mmol.
The figure to aim for is to get all (or almost all) readings below or at 8.0mmol, some even say 8.5.

It is hugely important not to push too hard for the lowest possible numbers because this new way of eating needs to be enjoyable or else you won't be able to keep it up over the many healthy years you have ahead of you. Controlling any/all forms of diabetes is a marathon, not a sprint!

If you want to completely avoid complications, aim for 7.

Will you always get there? Probably not. But that doesn't mean it shouldn't be the target.

 

[Angela64]

Sounds to me as if you’re not eating enough, especially with big increase of exercise. My HBa1C was 134!! No signs or symptoms, till wham - I felt ‘vacant’‍
Husband asked me all the questions for stroke - no, didn’t have a clue, phone 999 I said. Don’t know why I became sudden T2 then. I know know I have Haemochromatosis Compound variant and have the ailments it can cause ‍
I went low carb high fat, lost around 3 stone, which I’d put in since heart medication
I do have carbs, in moderation.
Looks like I may also developed None Alcoholic Fatty Liver Disease Someone said ‘diet’ fgs NO had enough, may as well drop off

 

[CatsFive]

You have several threads, so the advice you are getting is spread around.

 

[Prince4]

You have several threads, so the advice you are getting is spread around.

My mistake. I thought the first post was moderator blocked. So duplicated.

 

[Prince4]

I agree with @jjraak and would just add one more suggestion. If its possible and affordable, invest in Freestyle Libre so you can see trends for your blood glucose levels against food you eat and after training. It will help you make informed choices and HbA1c results will also be less of a surprise.

I have looked at this. However £25 a week is quite an expense. Having said that I probably used to spend that on takeaways......

 

[lovinglife]

If you want to completely avoid complications, aim for 7.

Will you always get there? Probably not. But that doesn't mean it shouldn't be the target.

Being in tight control as you suggest (aim for 7) or below does not guarantee that you will completely avoid complications, this statement is misleading, yes you have a better chance of avoiding complications if you have good control but there is no 100% sure fire way of avoiding complications, some are just luckier than others.

Incidentally many none diabetics will have a number of 7 or above at 2 hours if they have eaten a carb heavy meal, not just people with diabetes

 

[Hiitsme]

When I did Desmond Course they told us to aim at under 7 at all times including 2 hours after a meal. Not all will achieve this but good to try aiming this low.

 

[Liam E]

Being in tight control as you suggest (aim for 7) or below does not guarantee that you will completely avoid complications, this statement is misleading, yes you have a better chance of avoiding complications if you have good control but there is no 100% sure fire way of avoiding complications, some are just luckier than others.

Incidentally many none diabetics will have a number of 7 or above at 2 hours if they have eaten a carb heavy meal, not just people with diabetes

No it won't guarantee that you will completely avoid complications. I didn't say it would.

If you spend a significant amount of time with your blood glucose above 7 I can pretty much guarantee you will get complications sooner or later though.

 

[Liam E]

I have looked at this. However £25 a week is quite an expense. Having said that I probably used to spend that on takeaways......

You can learn a massive amount from just having one for a month and you might some find free one month trials.

You will be able see what food you tolerate well, and what ones you don't. Armed with that knowledge you can formulate a game plan that works for you long term.

 

[MrsA2]

I have looked at this. However £25 a week is quite an expense. Having said that I probably used to spend that on takeaways......

You don't need one all the time, and they offer the first for free. I use one about 2 or 3 times a year, the first was to see what was going on with various foods, subsequent ones are for when I'm not in charge of my own food such as holidays or business trips or when I just want to run a check on myself.
I found once i had seen what certain foods do to me I don't need to see those figures again - some are burned into my brain!
They can be informative and motivating but a T2 who learns doesn't need one continuously

 

[lovinglife]

No it won't guarantee that you will completely avoid complications. I didn't say it would.

If you spend a significant amount of time with your blood glucose above 7 I can pretty much guarantee you will get complications sooner or later though.

Errr yes you did (my bold)

If you want to completely avoid complications, aim for 7.

Will you always get there? Probably not. But that doesn't mean it shouldn't be the target.

 

[HSSS]

As I am cutting Carbs, I only having 2 meals a day i.e Porridge and fresh blueberries in the morning and fish and Green veggies for dinner ( my carbs have come down significantly) I had my first couple of night hypos given my lips went numb and HR went up , and it was terrifying. I had some mint sweets and an apple and was all ok after 15 mins or so .
Can anyone please give advice around how to avoid this? I was told that carb elimination is the crux of remission but clearly I am eating too little? I am almost tempted to have another bowl of oatmell late in the evening ( I don't tend to eat after 6 pm) so I don't hypo in middle of night?

I have a Aqu- check monitor- is there any advice on when and how to take readings to establish a baseline?

Thanks. in advance

If you are cutting carbs porridge is an odd thing to retain being 2/3 carbs. More oatmeal is likely to make things worse not better.

Where are the fats that are essential? And there is very little protein too. I strongly suspect you are simply eating too little food to sustain your body and exercise and that is the cause of feeling bad.

Hypos on Metformin alone would be most unusual, it simply doesn’t work that way. I’m not convinced that’s what happened especially without any bgl readings at the time. You really need to test when feeling the way you describe. Maybe it was a fast drop rather than a low one, maybe it was something else entirely (like your minimalist diet perhaps).