Advice please

[Jonah01]

Hi,

My mum has had a few HB1AC tests over the last couple of years. She is 66 and quite active doing multiple long walks every day.

Her results have gone like this.

The first score 41 in March 2017.
43 in July 2017
46 July 2018. Here she was told to see the diabetic nurse. She did this and has massively changed her diet and has been ultra strict. She has lost lots of weight (almost 1.5 stone) and now down to around 10 stone. she looks great and feels healthy.

She has been following various diets to help reduce the carbs. She basically doesn't eat them.

Blood test Oct 2018 showed 43 so she thought she was on the right track.

Since then she has been incredibly strict with her diet and doing really well.

Today she got her blood test results of 46!

She is very disappointed and upset as she has worked so hard.

The doctor hasn't suggested anything and said the test has an error margin of 2 or 3. He is happy with her.

I have told her if she eats healthy, exercises and is now at the perfect weight then forget about the test.

In reality is she close to being diabetic?

What is causing it to be high?

Thanks in advance for any help you can give me.

 

[Antje77]

Could you tell us what she typically eats in a day?

 

[Antje77]

Oh, I see now this is your first post, so welcome to the forum, @Jonah01 and Jonah's mom!
I'll tag @daisy1 for you, she'll come up with some useful information about diabetes, in case you haven't encountered it yet

 

[daisy1]

@Jonah01
Hello Jonah and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it both interesting and helpful.

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 147,000 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.

 

[Olufisayo]

@Jonah01
Hello Jonah and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it both interesting and helpful.

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 147,000 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.

Appreciation! I’ve learnt a lot from this forum. I don’t believe that diabetes is a death sentence again. I test my bg everyday. Now I observe that whenever I ate my dinner early (on light food) I go hungry at night and I won’t be able to have a deep sleep.

 

[Jonah01]

Thanks for everyone's replies.

I am going to order one of these

Diabetes Test Kit – Blood Sugar Tester– Blood Glucose Monitoring Kit – 50 Strips Included – Pain Free Lancing Device – for UK Diabetics in mmol/L by Sinocare AQ Smart

Hopefully we can then work out what food is causing an issue with my Mum.

As I mentioned she has cut out all of the bad carbs and doesn't have any treats at all.

She does eat a lot of vegetables and drinks black coffee so could possibly be one of these but have read coffee is a good thing!

She just told me she doesn't eat root vegetables.

What could it be?

 

[HSSS]

Other illness, stress, lack of sleep can all also have an effect. The test does have a bit of variability. I’m looking at it as having a small range I want to stay within rather than a specific number.

Dietdoctor.com has a fair few foods listed that might shed light on a possible cause, maybe something she eats a lot of thinking it’s lower than it is.

 

[Jonah01]

Hi,

Bit of feedback.

My mum tested her blood before eating (not fasting) and it was 119 mg/dl then 2.5 hours after her meal it was 195 mg/dl.

Haven't found out what she ate yet.

How do these scores convert?

Thanks

 

[HSSS]

https://www.diabetes.co.uk/blood-sugar-converter.html

 

[HSSS]

6.6 to 10.8

Something was too carby for her

 

[Jonah01]

She had a pork chop, cabbage and gravy.

 

[Jonah01]

Turns out I made a mistake when these tests were done.

Official results were 5.5 pre meal, 10.8 post meal and 6.6 2.5 hours post meal

 

[Phoenix55]

Hi @Jonah01 Your Mum has done really well and it is difficult to keep being motivated when the scores don't seem to add up. Testing on a regular basis and checking the ingredients will help, you may find that as well as reacting to carbs she reacts to grains so bread, thickening in gravy and sauces may cause a higher reading 2 hours post meal. It is a known link in the medical profession, I mentioned it to a relative who is a HCP in New Zealand and she recognised it immediately. Let your Mum find some 'treats' that she can enjoy. As high % chocolate as she can tolerate, a single square is enough, salami and cheese rolls, olives, different types of cheese all help to add variety to the diet without raising bg too much.

 

[Jonah01]

Yes all very odd to understand the scores.

Did it again and the results were 4.6 pre meal. 9 post meal and 4.6 90 mins post meal.

For her 3 months test to be 46 which is an average the results don't seem to correlate unless she is having massive highs

 

[HSSS]

Out of interest when is the post meal test? Could she be eating other foods you aren’t aware of? Not all meals as good as these two?

 

[Bluetit1802]

For her 3 months test to be 46 which is an average the results don't seem to correlate unless she is having massive highs

She is having some highs - she reached double figures from your post number #12.. How long after that meal was the test done?

The correct way to test is immediately before and again 2 hours after first bite. An additional test at 1 hour after first bite is also advisable when trying to work out if food choices are working. Keep records alongside a detailed food diary - all foods eaten including portion sizes, condiments, sauces, spreads, and of course drinks.

 

[HSSS]

And if there’s apparently been no rise at or before 2hrs and one would generally be expected ie carbs eaten then I’d add in another at 3hrs and even 4hrs to see if there is a delayed one as some foods take some time to hit their high and can be missed if testing stops at 2hrs.

 

[Jonah01]

Thanks.

We have been testing right before the meal then straight after the meal and a final test 90 ish minutes afterwards.

She is having some highs - she reached double figures from your post number #12.. How long after that meal was the test done?

The correct way to test is immediately before and again 2 hours after first bite. An additional test at 1 hour after first bite is also advisable when trying to work out if food choices are working. Keep records alongside a detailed food diary - all foods eaten including portion sizes, condiments, sauces, spreads, and of course drinks.