Food, exercise..getting it all wrong

[loubielou]

I could do with some help and advise. I have been T2 for a few years but recently made some changes. I have started running, but it doesn't seem to be having the effects I was hoping for. Have managed to lower HbA1c and lost some weight, but I have noticed raised BS levels after runs, is this to be expected? Really I don't know what to eat and when before runs. I find it hard to eat a meal before running, but feel like I am lacking energy when I go out. I run about 3 miles 2/3 times per week. All help welcomed. Thanks

 

[Rachox]

Hello loubielou and welcome to the best corner of the internet! First I’ll tag in @daisy1 who’ll post an info pack for you.
Can you tell us a little bit more about yourself so we can help you? Are you on medication? And what is a typical days food for you? Do you know your exact HbA1c numbers?

 

[loubielou]

Hello loubielou and welcome to the best corner of the internet! First I’ll tag in @daisy1 who’ll post an info pack for you.
Can you tell us a little bit more about yourself so we can help you? Are you on medication? And what is a typical days food for you? Do you know your exact HbA1c numbers?

Thank you! I take Metformin x2, Forxiga and sitagliptin x1 each per day. Last HbA1c was 63,(Mar 18), In Oct 17 it was 77(!) Sept 16 it was low 60's but not sure of exact numbers. Breakfast tends to be 2 boiled eggs and a small piece of brown toast, lunch is soup or a salad and dinner portion of meat or fish with veg and 1 potato. I'm a fairly plain eater and very occasional drinker, its a G+T if I bother.

 

[Rachox]

I can only tell you that I’ve managed to get my HbA1c down to non diabetic levels with medication, that is Metformin and diet. I haven’t been able to do a huge amount of exercise due to arthritis. I believe it only helps a very small amount compared to what you eat anyway. I have reduced my carb intake which is safe to do on just Metformin, I think you’d have to be very careful doing this on your selection of meds as you’ll be more at risk of hypos. I hope someone with experience of your meds will come along soon to help further.

 

[loubielou]

I can only tell you that I’ve managed to get my HbA1c down to non diabetic levels with medication, that is Metformin and diet. I haven’t been able to do a huge amount of exercise due to arthritis. I believe it only helps a very small amount compared to what you eat anyway. I have reduced my carb intake which is safe to do on just Metformin, I think you’d have to be very careful doing this on your selection of meds as you’ll be more at risk of hypos. I hope someone with experience of your meds will come along soon to help further.

I was worried about exercise as I have some knee issues, but the extra lbs I'm carrying don't help that either. So far, the knees are holding up well! Thank you for your help so far, its much appreciated.

 

[ringi]

I just did a quick google and I don't think there is that much risk of hypos with Metformin. Forxiga and sitagliptin. The important thing is to test often and be ready to cope with a hypo if you get one. Also being on Forxiga you must know the signs of DKA, as you can get it without your BG increasing much.

Rather than running, trying walking on a treadmill with it set at a steep angle, this puts a lot less load on the knee, or swimming, or cycling. The other option is to use the resistance training machines at a gym.

The increased BG with running is likely due to your body getting your liver to put some sugar into your blood, but the liver giving more than was asked for due to insulin resistance. The exercise is still of benefit, but you have made sugar that was hidden visible. As your exercise more your insulin resistance will reduce.

The brown toast when you eat it will quickly be converted into sugar, try replacing it with bacon or a bit of cheese. Check the carb content of the soup you are having for lunch. I don't eat potato due to their carb content, but they are much less of an issue then bread.

What drinks do you tend to have in a day?

 

[millenium]

I could do with some help and advise. I have been T2 for a few years but recently made some changes. I have started running, but it doesn't seem to be having the effects I was hoping for. Have managed to lower HbA1c and lost some weight, but I have noticed raised BS levels after runs, is this to be expected? Really I don't know what to eat and when before runs. I find it hard to eat a meal before running, but feel like I am lacking energy when I go out. I run about 3 miles 2/3 times per week. All help welcomed. Thanks

You will need to collect some data like what is your bg level before exercise and after. Also, get the data for before and after meal. Use those data to tune your carb intake and exercise duration and intensity. Generally when the intensity of exercise is high and the bg level gets too low during exercise, the liver will release its glucose reserve to the bloodstream to help upkeep a certain level. When doing so, it often overdo it for a diabetic whose feedback system is not as perfect as a non. This is why the bg level gets a bit highef before it is corrected. Perhaps a weekly routine that is more regular and lower in duration n intensity may suit u better.

 

[loubielou]

I just did a quick google and I don't think there is that much risk of hypos with Metformin. Forxiga and sitagliptin. The important thing is to test often and be ready to cope with a hypo if you get one. Also being on Forxiga you must know the signs of DKA, as you can get it without your BG increasing much.

Rather than running, trying walking on a treadmill with it set at a steep angle, this puts a lot less load on the knee, or swimming, or cycling. The other option is to use the resistance training machines at a gym.

The increased BG with running is likely due to your body getting your liver to put some sugar into your blood, but the liver giving more than was asked for due to insulin resistance. The exercise is still of benefit, but you have made sugar that was hidden visible. As your exercise more your insulin resistance will reduce.

The brown toast when you eat it will quickly be converted into sugar, try replacing it with bacon or a bit of cheese. Check the carb content of the soup you are having for lunch. I don't eat potato due to their carb content, but they are much less of an issue then bread.

What drinks do you tend to have in a day?

Thank you for getting back to me, what you say about the insulin resistance makes sense, so will bear that in mind. The carb advise is helpful as well. I have to honest, I wasn't aware of the risk of DKA when taking Forxiga, but will also bear that in mind. Fortunately, I drink plenty during the day- mostly tea (no sugar) and water. Thanks again

 

[loubielou]

You will need to collect some data like what is your bg level before exercise and after. Also, get the data for before and after meal. Use those data to tune your carb intake and exercise duration and intensity. Generally when the intensity of exercise is high and the bg level gets too low during exercise, the liver will release its glucose reserve to the bloodstream to help upkeep a certain level. When doing so, it often overdo it for a diabetic whose feedback system is not as perfect as a non. This is why the bg level gets a bit highef before it is corrected. Perhaps a weekly routine that is more regular and lower in duration n intensity may suit u better.

Great ideas, thanks. I have been running a lot on my own, and have recently joined a local club. This means I am running in the evening rather than the morning, hence why I am getting in a pickle with my food. However the group atmosphere is helping to keep me focused. Swings and roundabout eh!

 

[NicoleC1971]

i advise type 2 clients (am a trainer and a type 1 who suffers from exercise induced glucose spikes too!) to try and do their exercise after carbs but think that the benefits of running in a group may outweigh changing the timing of your run.
The other point of exercise is to make your muscles bigger and therefore more insulin sensitive. This doesn't mean joining a gym but can just be body weight stuff like squats, dips from a bench or chair and press ups against a wall to engage the large sugar burning muscles.
Re spikes, the less carb you eat the better at fat burning your body will be i.e. it will be more inclined to take fuel from your storage tanks when insulin isn't around dealing with glucose you've eaten but if you are working intensely the liver dump may be inevitable for a while whilst you adjust. However I suspect what's important is what happens 2 hours aferwards i.e. how well your body corrects itself so please test if you can.
Finally the exercise will make you metabolically healthier and makes you feel great (I think!) but weight loss will be as an indirect consequence of this so do continue with the dietary changes because its much more important.

 

[loubielou]

i advise type 2 clients (am a trainer and a type 1 who suffers from exercise induced glucose spikes too!) to try and do their exercise after carbs but think that the benefits of running in a group may outweigh changing the timing of your run.
The other point of exercise is to make your muscles bigger and therefore more insulin sensitive. This doesn't mean joining a gym but can just be body weight stuff like squats, dips from a bench or chair and press ups against a wall to engage the large sugar burning muscles.
Re spikes, the less carb you eat the better at fat burning your body will be i.e. it will be more inclined to take fuel from your storage tanks when insulin isn't around dealing with glucose you've eaten but if you are working intensely the liver dump may be inevitable for a while whilst you adjust. However I suspect what's important is what happens 2 hours aferwards i.e. how well your body corrects itself so please test if you can.
Finally the exercise will make you metabolically healthier and makes you feel great (I think!) but weight loss will be as an indirect consequence of this so do continue with the dietary changes because its much more important.

Thank you, and again some really useful information. Its good to understand whats happening from people like yourself who are either experiencing the same or working with people who are. I will start testing 2hrs after running as well and see how that goes. I can't say that I'm loving the running, its certainly not a natural thing for me to do. However, I feel amazing after and hope it will get easier as I get to grips with all this, get stronger and fitter. Thanks again for you response.

 

[daisy1]

@loubielou

Hello Loubielou and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it useful. Ask as many questions as you need to and someone will help.


BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 235,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.
Take part in Diabetes.co.uk digital education programs and improve your understanding. Most of these are free.

• Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why
  
  
• Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
  

 

[loubielou]

@loubielou

Hello Loubielou and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it useful. Ask as many questions as you need to and someone will help.


BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 235,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.
Take part in Diabetes.co.uk digital education programs and improve your understanding. Most of these are free.

• Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why
  
  
• Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.

Thank you, lots to read through, but really helpful. I'm so grateful for the help and support.

 

[There is no Spoon]

I have noticed raised BS levels after runs, is this to be expected?

Hi loubielou,
Think of it like this you body takes a little while to catch up.
So it takes time for the signal I have stopped running to tell your liver to stop dumping sugar into your blood stream.

This is not a bad thing it means your body is breaking down fat to get that extra sugar and if you check your bloods you should see the rise drop quite quickly as it shunted to the muscles to replenish them. Muscles will continue to burn energy up to 24 hours after you stop exercising.

You mentioned lack of energy is this just stamina?
Something you build up over time.

If it's an option for you look at High Intensity Training HIT a 10 second run flat out full speed has been proven to have the same, if not more, benefit as going for a 3 miles 2/3 times per week. You will find by doing HIT you will increase your stamina and the 3 mile run will be less of a drain on your energy.

Sounds crazy I know.

 

[loubielou]

Hi loubielou,
Think of it like this you body takes a little while to catch up.
So it takes time for the signal I have stopped running to tell your liver to stop dumping sugar into your blood stream.

This is not a bad thing it means your body is breaking down fat to get that extra sugar and if you check your bloods you should see the rise drop quite quickly as it shunted to the muscles to replenish them. Muscles will continue to burn energy up to 24 hours after you stop exercising.

You mentioned lack of energy is this just stamina?
Something you build up over time.

If it's an option for you look at High Intensity Training HIT a 10 second run flat out full speed has been proven to have the same, if not more, benefit as going for a 3 miles 2/3 times per week. You will find by doing HIT you will increase your stamina and the 3 mile run will be less of a drain on your energy.

Sounds crazy I know.

Hi, and thank you for your reply. Its good to know what thats happening is what should be happening. Lots to think about and take on board. I have heard about HIIT training and the positive reactions to it- will have a look and see whats available locally- thanks

 

[ringi]

One way to do HIIT is to run as fast as you can up each hill, the slow down to recover before the next hill.