Gradual Rise In Bg

[johnrubinstein]

I was diagnosed with T2 in January. My A1C was 51. In 4 months I went down from 83kg to 70kg and brought down my A1C to 44.

But I’ve noticed that in recent weeks my FBG has been creeping up from the upper 5s to the mid 6s and a couple of times it’s hit the low 7s. My 90 day overall average has crept up from 6 to 6.3.

Nothing has changed except that I brought my weight loss to an end seeking to maintain it at 70kg.

Essentially, I’m on on an LCHF diet. My FitnessPal app shows that, on average, my average carb consumption per day is 40-50 grams. Cals per day average 2100.

I do not eat any fruit, pasta, rice, potatoes, etc. I do not eat any cakes, cookies, ice cream, chocolate, etc. I do eat a lot of full fat Greek yogurt, cheddar cheese, omelettes, chicken, fish - you get the idea.

OK, now that the preamble is over, here’s the question: assuming a scenario where my BG continues to creep up, at what point do i start to consider meds? My doctor told me about 3 months ago that diabetes is progressive and that I’d eventually have to take meds. I just want to understand roughly when that point is reached.

Thanks

John

 

[johnrubinstein]

Meant to say that my average DAILY carb consumption is 40-50 grams.

 

[Mal37]

Meant to say that my average DAILY carb consumption is 40-50 grams.

If it were me then I would try leaving out breakfast a couple of days per week and lowering the carbs slightly?
Do you ever do any fasting?
It gives the Pancreas a rest.
I hope others will offer suggestions too, but this would certainly be 'my' next move. Hope it helps

 

[bulkbiker]

Yep I would agree with @Mal37 above. Try skipping the odd meal also where are your carbs coming from? If you are eating as you say then your carb count should be almost zero?

 

[Prem51]

Your gp was giving the standard NHS prognosis in saying T2 diabetes is progressive. Other HCPs and forum members would disagree with that. It can be controlled.
Well done on your HbA1c and weight reductions. Your fbgs might be creeping up for different reasons, including Dawn Phenomenon.
My fbgs averaged around 6.3. Over the last few weeks they crept up to the high 6s and low 7s, but now over the last 3 or 4 days they seem to have gone down again to around 6.3. I don't know why. I am quite happy with any fbg readings lower than 7.
I take more from my HbA1c test. Thenext is due in October.

 

[johnrubinstein]

Thanks guys. Very helpful. Want to follow up on a couple of the replies, but rushing to a bunch of meetings. Catch you later!

 

[johnrubinstein]

Back again. @bulkbiker, in answer to your query and looking at my FitnessPal app, my carb consumption for yesterday was:

10% full fat Greek yoghurt = 19 grams (yes, lots of Greek yoghurt split into morning/afternoon)

Mozzarella and tomato salad = 9 grams

Hot smoked salmon flakes = 3 grams

Steamed broccoli = 2 grams

25 grams mixed nuts = 2 grams

That’s fairly typical (average, a little higher, but not much more)

@Mal37, I have considered intermittent fasting but, here, my concern is further weight loss. I do t want to go below 70kg. Ensuring that I eat 3 meals a day is what it takes me to keep my weight up — unless someone can show me an alternative, which permits fasting. Always willing to listen..

Now, back to my original question. I have been well persuaded by this forum that diet and exercise are key to self management. But, surely, you will agree that there may arise circumstances where, despite best efforts BG levels continue to rise — such that the use of meds becomes a necessary supplement. My wish is merely to understand at what point a discussion about meds becomes relevant.

John

 

[Mal37]

Back again. @bulkbiker, in answer to your query and looking at my FitnessPal app, my carb consumption for yesterday was:

10% full fat Greek yoghurt = 19 grams (yes, lots of Greek yoghurt split into morning/afternoon)

Mozzarella and tomato salad = 9 grams

Hot smoked salmon flakes = 3 grams

Steamed broccoli = 2 grams

25 grams mixed nuts = 2 grams

That’s fairly typical (average, a little higher, but not much more)

@Mal37, I have considered intermittent fasting but, here, my concern is further weight loss. I do t want to go below 70kg. Ensuring that I eat 3 meals a day is what it takes me to keep my weight up — unless someone can show me an alternative, which permits fasting. Always willing to listen..

Now, back to my original question. I have been well persuaded by this forum that diet and exercise are key to self management. But, surely, you will agree that there may arise circumstances where, despite best efforts BG levels continue to rise — such that the use of meds becomes a necessary supplement. My wish is merely to understand at what point a discussion about meds becomes relevant.

John

Referring to the fasting, and your reluctance to lose weight ... could you miss breakfast but then eat more for your other two meals ... so that your pancreas gets a rest but you still have enough calories to maintain present weight? Just a suggestion, but could be helpful?

 

[bulkbiker]

I was just about to suggest the above.. just because you aren't having breakfast doesn't mean you have to keep your other meals the same size.. I am currently only eating one meal a day but still manage over 2k calories easily.. I just have a big meal.
Not that I think calories matter all that much but I know some do...

 

[Bluetit1802]

Is it just your FBG that has increased? What about the difference between pre and post meals? Has this also gone up or is it the same or better? The FBG is not an ideal marker for how well you are doing because there are so many variables. It is how much you rise from before to after that matters, in addition to how long it takes to get back to where you started.

 

[bulkbiker]

Now, back to my original question. I have been well persuaded by this forum that diet and exercise are key to self management. But, surely, you will agree that there may arise circumstances where, despite best efforts BG levels continue to rise — such that the use of meds becomes a necessary supplement. My wish is merely to understand at what point a discussion about meds becomes relevant.

That is something that you will have to discuss with your doctor as they will be the one who will be writing the prescription. Personally I would do almost anything to avoid taking medication (mainly because the last time metformin, which is the most likely, gave me dreadful side effects).

 

[johnrubinstein]

@Bluetit1802, FBG has crept up, as have readings during the day. The difference between pre and post meals has remained in the region of 0.75 - 1.5.

@Mal37 and @ bulkbiker, I guess I could try missing breakfast and eating more at other times (that thought had occurred to me ), but unlike @bulkbiker I don’t find that easy to do. Still, I will give it a whirl — and update my fellow travellers in due course.

 

[Mal37]

@Bluetit1802, FBG has crept up, as have readings during the day. The difference between pre and post meals has remained in the region of 0.75 - 1.5.

@Mal37 and @ bulkbiker, I guess I could try missing breakfast and eating more at other times (that thought had occurred to me ), but unlike @bulkbiker I don’t find that easy to do. Still, I will give it a whirl — and update my fellow travellers in due course.

If you cannot face too much on the plate then just make sure the plate consists of fatty foods (only good fats of course)

 

[Bluetit1802]

But I’ve noticed that in recent weeks my FBG has been creeping up from the upper 5s to the mid 6s and a couple of times it’s hit the low 7s. My 90 day overall average has crept up from 6 to 6.3.

Has this happened since the weather became so warm? Many people find their blood sugar levels increase when it is hot.

 

[johnrubinstein]

@Bluetit1802. Really? How interesting. Yes, that’s definitely a possible correlation. Thanks for that!

 

[Bluetit1802]

@Bluetit1802. Really? How interesting. Yes, that’s definitely a possible correlation. Thanks for that!

We do get threads about it on the forum, and it does happen to some of us. In fact I think my own levels are a bit raised at the moment with no other explanation.

 

[johnrubinstein]

@Mal37, @Bluetit1802, @bulkbiker, and Pem51. Thanks guys. Your advice has had results and this is the promised update.

Since my original post on June 26, I’ve cut out breakfast. This means that, generally I do not eat past 9pm and fast until around 1-2pm the following day. In addition, I’ve taken to briskly walking 3 miles each morning before getting to the office.

It’s been quite dramatic. My BG levels have come down significantly. Whereas, at the time of posting, my average for the previous 7 days was touching 6.5 mmol/L, today it’s showing 5.4. As follows:

Interestingly, walking has had a very marked effect. On any given day, a comparison of BGLs before and after the walk can show a drop of as much as 1.0.

In short a big thank you to you all for giving me a steer and setting me along these further life style changes. Just hope I can keep things up.

John

 

[bulkbiker]

@Mal37, @Bluetit1802, @bulkbiker, and Pem51. Thanks guys. Your advice has had results and this is the promised update.

Since my original post on June 26, I’ve cut out breakfast. This means that, generally I do not eat past 9pm and fast until around 1-2pm the following day. In addition, I’ve taken to briskly walking 3 miles each morning before getting to the office.

It’s been quite dramatic. My BG levels have come down significantly. Whereas, at the time of posting, my average for the previous 7 days was touching 6.5 mmol/L, today it’s showing 5.4. As follows:

View attachment 27566

Interestingly, walking has had a very marked effect. On any given day, a comparison of BGLs before and after the walk can show a drop of as much as 1.0.

In short a big thank you to you all for giving me a steer and setting me along these further life style changes. Just hope I can keep things up.

John

Well done you sir.. great efforts augmented by great results. You did the work we just pointed you in the right direction.. many congratulations!

 

[Mal37]

@Mal37, @Bluetit1802, @bulkbiker, and Pem51. Thanks guys. Your advice has had results and this is the promised update.

Since my original post on June 26, I’ve cut out breakfast. This means that, generally I do not eat past 9pm and fast until around 1-2pm the following day. In addition, I’ve taken to briskly walking 3 miles each morning before getting to the office.

It’s been quite dramatic. My BG levels have come down significantly. Whereas, at the time of posting, my average for the previous 7 days was touching 6.5 mmol/L, today it’s showing 5.4. As follows:

View attachment 27566

Interestingly, walking has had a very marked effect. On any given day, a comparison of BGLs before and after the walk can show a drop of as much as 1.0.

In short a big thank you to you all for giving me a steer and setting me along these further life style changes. Just hope I can keep things up.

John

Wonderful news and we are all delighted I'm sure that I speak for everyone! We feel so much better, don't we, when we are in control of our health and fitness somewhat? I know it always gives me a lift to see folk making improvements to their well being, just as it makes my own day to see that I am conquering diabetes. Onward and Upwards John