Confused Now

[Suzieb1]

Been diagnosed with Type 2 for around 12 to 14 years and was in denial until last year when I got a letter telling me that I had mild diabetic retinopathy. My HBA1c was high I can’t remember exactly how high but 13 sticks in my mind. That panicked me so I took the bull by the horns and started rigorous testing of my bloods using a stash of strips I’d stockpiled. I discovered I reacted badly to carbs so started a Keto way of eating in August. I lost 2 1/2 stone and entered the unknown territory of being normal weight and having a normal BMI of 23. I stopped taking most of my meds apart from Metformin SR and Gliclazide which I reduced to one a day as I got the odd hypo. Next HbA1c result I got a call from GP saying she thought I should retest as it had come back very low, in the non diabetic range. I explained what I had been doing; expecting to be told off but no she congratulated me effusively and said to keep up the good work. I was over the moon until I went to pick up my repeat prescription to find Gliclazide had been completely withdrawn, along with test strips and lancets. I felt as if I’d been sabotaged. I rang the surgery and told them this and was told I did not need to test at all because I would not have hypos without the Gliclazide. I explained that after being on such a strict low carb diet I was hoping to reintroduce some low GI foods for more variety and after arguing for a while was told I could have 50 strips as a one-off. Great!! They’d last me about 20 days. I bought myself a Codefree meter and strips as they are cheaper than the Freestyle ones, so I am breaking the rules and still testing. Now this is why I am confused... since stopping the Gliclazide I find I can barely eat anything with a hint of starch or sugar - even in small quantities. No legumes, whole grains, fruit etc. My diet is even more restrictive and I’m finding it hard to control blood sugars. Now it is rarely below 7 which I’m not happy with. I felt much better when it was in the 4’s and 5’s. I’m planning on getting an HbA1c next week and asking to be put back on Gliclazide but what am I to do if they refuse? I can’t struggle with this diet where I can’t eat even really small portions of cabbage, cauliflower etc without a spike. Can anyone help me please?

 

[Guzzler]

Hello and welcome. I gave you a trophy for your great efforts in lowering your A1c and for facing up to this condition. Please accept a hug for the refusal on strips, once off blood glucose lowering meds the NHS refuses to supply meters and strips.

As to your current problem of raised bg due to carb content of your diet I will leave that to other members who have experience of coming off Glic to advise you.

It might be a good idea to give an average day's menu, we may be able to help you tweak your diet for better results.

Tagging @daisy1 for the info pack offered to all newcomers.

 

[Suzieb1]

Thank you. Ok, typical days menu:Incidentally carb content is normally less than 20 g per day.

Breakfast: Scrambled Egg, 4 button mushrooms boiled. Coffee with tbsp lacto free semi skimmed milk.

Snack: stick of celery With desertspoon of Almond butter.

Lunch: Lettuce 1 cup, 4 slices cucumber, 2 cherry tomatoes, 2 radishes, small slice of onion, tsp mayonnaise and 2oz cooked meat.

Snack: 1/2 oz Wensleydale or mini babybel and 5 pecans

Dinner: 2oz cabbage, cauliflower or broccoli boiled, 4 green beans. Meat or fish. Occasional sugar free jelly with 1 tsp of cream.

Anymore than this and I’m up to 8.5 two hours after.

 

[Guzzler]

Thank you. Ok, typical days menu:Incidentally carb content is normally less than 20 g per day.

Breakfast: Scrambled Egg, 4 button mushrooms boiled. Coffee with tbsp lacto free semi skimmed milk.

Snack: stick of celery With desertspoon of Almond butter.

Lunch: Lettuce 1 cup, 4 slices cucumber, 2 cherry tomatoes, 2 radishes, small slice of onion, tsp mayonnaise and 2oz cooked meat.

Snack: 1/2 oz Wensleydale or mini babybel and 5 pecans

Dinner: 2oz cabbage, cauliflower or broccoli boiled, 4 green beans. Meat or fish. Occasional sugar free jelly with 1 tsp of cream.

Anymore than this and I’m up to 8.5 two hours after.

Your diet looks great to me. Perhaps a tad too light on fats, perhaps? Fats may slow down the absorption of the few carbs there but I am Metformin/diet controlled so I will let the more experienced members advise from here. Well done on the low carbing, great work.

 

[Suzieb1]

Your diet looks great to me. Perhaps a tad too light on fats, perhaps? Fats may slow down the absorption of the few carbs there but I am Metformin/diet controlled so I will let the more experienced members advise from here. Well done on the low carbing, great work.

Thank you. I intend to stay low carb but would like more variety with some fruit and different veg like I had when I was on Gliclazide and Metformin. I don’t really want to lose more weight or I’ll disappear and really would like my blood sugars in the 4’s and 5’s again as I feel so much better at that level. Is there any chance the doc would make my life easier and re-prescribe Glic do you think? Oh but then I guess they’d have to reinstate my strips and lancets too...

 

[Guzzler]

Thank you. I intend to stay low carb but would like more variety with some fruit and different veg like I had when I was on Gliclazide and Metformin. I don’t really want to lose more weight or I’ll disappear and really would like my blood sugars in the 4’s and 5’s again as I feel so much better at that level. Is there any chance the doc would make my life easier and re-prescribe Glic do you think? Oh but then I guess they’d have to reinstate my strips and lancets too...

I suppose that would depend on your next HbA1c. Some doctors will take notice of your home bg readings others won't. If you think you would be happier on Glic then you can ask your GP or Diabetes Specialist nurse. I beleive that whatever makes us feel well and keeps our bg nice and gentle is such an individual thing and when we find a happy medium we thrive.

 

[daisy1]

@Suzieb1

Hello Suzie 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 be able to 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.
  

 

[Daibell]

Hi. It sounds like you have been caught in a bit of a trap. If you do need Glic then it's possible you are not T2 but late onset T1 but in the early stages; I'm guessing of course. You mention you don't want to lose any more weight and being thin is another pointer to T1. The problem is you have been low-carbing so well it may have masked any underlying low insulin production (which can point to T1). I would continue to buy strips and measure having a slightly higher level of good carbs and make an appointment to see the GP with the readings. Hopefully the GP will prescribe a low Glic dose if he/she can see that there is a need

 

[Mr_Pot]

Thank you. Ok, typical days menu:Incidentally carb content is normally less than 20 g per day.

Breakfast: Scrambled Egg, 4 button mushrooms boiled. Coffee with tbsp lacto free semi skimmed milk.

Snack: stick of celery With desertspoon of Almond butter.

Lunch: Lettuce 1 cup, 4 slices cucumber, 2 cherry tomatoes, 2 radishes, small slice of onion, tsp mayonnaise and 2oz cooked meat.

Snack: 1/2 oz Wensleydale or mini babybel and 5 pecans

Dinner: 2oz cabbage, cauliflower or broccoli boiled, 4 green beans. Meat or fish. Occasional sugar free jelly with 1 tsp of cream.

Anymore than this and I’m up to 8.5 two hours after.

Not much help but just an observation. I am a diet controlled type 2 BMI 23, only moderate amounts of exercise as I am 70. But, I eat much more than that, maybe 3 or 4 times as much, including a lot of protein! As we always say we are all different but I just mentioned it because I think you need a different solution to control your BG rather than such a small amount of food, it is not surprising you are thin.