Type 2 Just gone on insulin and my sugars are worse than ever

Dr Snoddy

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So sorry if I sound harsh. I just get so upset when the current medical advice makes so many people worse and not better and when people are told things that are patently not true.
 

Lakeslover

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In a way you don’t need to believe blindly either your nurse, or the people here (including me) who have lowered their blood sugars using low carb. Give it a go for 1 week, test before and two hours after meals (keep a close check for sudden drops and whether you need to adjust your insulin). You will see by then whether it is starting to work for you or not.

for breakfast could you have scrambled egg, or cheese omelette? Or Greek full fat yoghurt with a few berries or walnuts, or even a plate of cold meats and cheeses continental style. All are low carb and fill you up.
 
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finzi1966

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Yes, I’m so sorry, any irritation was not aimed at you AT ALL, it was aimed at your diabetic nurse. It is perfectly reasonable that you have been doing what you think is the right think by following their instructions. But their instructions are very likely to be making your blood sugars worse. Because what raises blood sugar is carbohydrates. They are the WORST thing for a diabetic to have too much of. Non-diabetics can cope fine because they produce the appropriate amount of insulin at the right time and their cells respond to it correctly. You can’t do that. So the only way to reliably fix the blood sugar (although meds will also help) is minimising the amount to carbohydrates you put in.

Things you could have for breakfast? I’d suggest maybe eggs, bacon, avocado, sliced chicken, salmon, sausage, spinach. Same as you’d have for other meals, really. Breakfast doesn’t need to be special food and it DEFINITELY doesn’t need to be carbohydrates. In fact an odd thing about many of us is that we are LESS able to cope with carbs at breakfast than later times in the day.
 
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HSSS

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Im not sure what to think when my DN is telling me my carb intake is fine yet everyone here seems to be telling me different. I think I might try a fish and vegetable diet and see if that makes a difference . I was told to have porridge for breakfast as long as it was measured and only a small amount of sugar but sometimes I put chia seeds on it which are very low carb. I really dont know how i would manage on 50 g per day as we need carbs for energy and I am diagnosed anaemic due to previous low carb and also b 12 deficiency
Can I ask you what your diet is as I’d love to get down to 50 g but also keep my anaemia at bay
I’m another that is mystified why they are linking low b12 and iron to lack of carbs. Typically they come from animal sources, especially meat, not carbs which are usually very lacking in these nutrients. I too struggle with the same issues and have researched it, a lot! Some poor advice if it’s coming from your nurse and it makes me question her knowledge even more.

We need energy. We don’t have to get it from carbs. Humans are dual fuel and can run of fats and ketones as well as glucose. If I ate anywhere near that amount of cars a day I’d be on insulin rather than at non diabetic levels I reckon . Blimey if I even ate your meals worth 60-80 in a day I’d be on something rather than no meds and much higher levels.

your DN is repeating the official guidance. The guidance is unambitious, not adapted to individuals and is a large part of the reason why type 2 is seen as progressive. The reason a lot of us in here say differently is because we tried the official way and it simply didn’t work. Maybe look up and send your dn the stuff dr David unwin has prepared to educate fellow professionals. It qualifies as their additional training.

As to your next steps I’d reduce the carbs more (and add in plenty of meat instead for the iron, b12 and very low glucose) and watch carefully with my meter. If you improve you know the carbs are the cause. If you go too low you need less insulin

If you don’t improve then I’d be asking to the DN to check how much insulin I actually produce still. If it’s very low then upping the insulin is the only option. If it’s actually high your problem is insulin resistance. It is for the vast majority or type 2 as an inherent part of the disease, even if eventually they also give up producing insulin as their pancreas gets “exhausted” from many years of overproduction. Adding gliclazide and insulin to already high levels adds to the problem in the long term as it adds to insulin resistance even whilst short term reducing blood glucose.
 

daffy1

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Thanks for all you help and advice. I’m trying a healthy day today
Poached egg on whole meal
Baked salmon and salad
Yoghurt and chia seeds
Apple
Ill let you know the outcome and if it makes a big difference, but when I was in hospital I had to semi fast for a day and the only thing I was given was vegetable soup and water and my sugars were still high at 13.5 so it’s a puzzle
Ive checked my sugars today and on waking 14.5 (7am) now 12.5 (12.30pm)
 
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Hertfordshiremum

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385
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LADA
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Thanks for all you help and advice. I’m trying a healthy day today
Poached egg on whole meal
Baked salmon and salad
Yoghurt and chia seeds
Apple
Ill let you know the outcome and if it makes a big difference, but when I was in hospital I had to semi fast for a day and the only thing I was given was vegetable soup and water and my sugars were still high at 13.5 so it’s a puzzle
That’s great, definitely give it a go. The whole meal bread might effect today’s results though so give it a few days to see what happens. I was told the same by a diabetic nurse to start with and when I showed her a Libre chart with a record of low carb eating she backed down.
I still think you should go back to the doctor and request a c-peptide test as you may be able to eat some of the carbs you are going to try and cut out if you had some fast acting bolus insulin, you may need this anyway in the future. Only giving you Levemir which is slow acting background insulin won’t solve your problem of high blood sugar after eating. Have you read the book by Dr Bernstein The diabetes solution? On Amazon, great explanations, certainly gives you a lot of information to make a choice. Best wishes, fingers crossed the next few days go really well for you.
 
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lucylocket61

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I wonder if the nurse has somehow decided to give you advice for a type 1 diabetic simply because you are on insulin? If so, she should know the two types are different.

It takes time to get your blood sugar levels down
 

HSSS

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Thanks for all you help and advice. I’m trying a healthy day today
Poached egg on whole meal
Baked salmon and salad
Yoghurt and chia seeds
Apple
Ill let you know the outcome and if it makes a big difference, but when I was in hospital I had to semi fast for a day and the only thing I was given was vegetable soup and water and my sugars were still high at 13.5 so it’s a puzzle
Ive checked my sugars today and on waking 14.5 (7am) now 12.5 (12.30pm)
It takes more than one day usually and that soup might have had loads of potatoes for example. The wholemeal might keep levels up a bit, as might the yogurt depending on which one it is and how many carbs. Apples aren’t the best option for fruit (berries are the best) but not awful. Overall a definite improvement and probably wise to step it down gradually anyway. If you’re hungry increase the proteins and natural fats (which I can’t see anywhere on your list btw) as these fill you up more without increasing blood glucose levels.
 

HSSS

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I’d also say if your condition is as a result of a damaged pancreas from the medication then it’s now being referred to type 3c by some drs, not type 2 which is classically insulin resistant not lacking. Type 3c has a lot more in common with type as insulin production is the problem even if the causes are different. There some info on this on the main diabetes.co.uk site which is a lot more than just this forum. Click the home button often in the top left of the screen and look around.
 

Dr Snoddy

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Thanks for all you help and advice. I’m trying a healthy day today
Poached egg on whole meal
Baked salmon and salad
Yoghurt and chia seeds
Apple
Ill let you know the outcome and if it makes a big difference, but when I was in hospital I had to semi fast for a day and the only thing I was given was vegetable soup and water and my sugars were still high at 13.5 so it’s a puzzle
Ive checked my sugars today and on waking 14.5 (7am) now 12.5 (12.30pm)
Definitely on the right track! If this leaves you feeling hungry may I suggest the following tweaks.
2 eggs instead of one or mashed avocado (and a dash of chilli?) under the eggs.
An olive oil based dressing on your salad maybe with a nice piece of cheese for dessert.
Full fat plain yoghurt and berries.
You may be concerned about the fat intake but replacing the calories that would have come from carbohydrates is important as you are a normal weight and the weather is cold!
 
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finzi1966

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Our sugars do funny things. Sugar in your blood doesn’t only come from what you eat - your liver also manufactures it, and it particularly does so when it perceives there is a need, eg at dawn when you haven’t eaten all night, or if you’re fasting. Again, normally this is a good thing, because it’s no good for people to go hypo just because they missed lunch. But because you are diabetic, the system again doesn’t work quite how it should - the liver is stuffed full of excess glucose, it overshoots, and as a type 2 you are probably insulin resistant so instead of the body’s insulin bringing the sugar back to normal levels after a liver dump, it remains high.

If you stick to a low carb diet (and that menu you posted above sounds fabulous!) gradually the liver will get rid of its excess and you will hopefully also become less insulin resistant.

My fasting sugars were 8-9 a few months ago, now they’re 5-6. Mostly this has been down to a low carb diet (I do take meds too although not insulin).
 
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MeiChanski

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Hello,

I think you need to highlight and demand a c peptide test to determine how much and how little insulin you’re producing.

You also need to understand that levemir isn’t designed to lower blood sugars, it’s a basal insulin that keeps your blood sugars stable through out the day.

Also whole meal bread isn’t any better than white bread except fibre content.

Anemia and B12 - you can get iron and B 12 from low carb sources such as meat and veg.

Keep testing and see what works for you, be mindful of hypos too.
 
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daffy1

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There was a definite improvement today
Yesterday’s was 14.5 on waking
Lunch. 12.5
Bedtime 9.6
That’s the lowest they’ve been in weeks
But this morning on rising it was 8.9 but when I woke in the middle of the night it was 6.4 so thanks all for the diet recommendation. I wont contact the DN for now but see if this continues over the next week . Ive plent6 of fish and meat in so ill go and buy yoghurt and berries and carrots to snack on. I cant believe I’ve been blinding accepting all the info that the DN
Has been giving me about carbs. I’m now trawling the the section on what have you eaten today to get ideas
Thanks once again for all the help
 
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Dr Snoddy

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Hi Daffy, that is great news. You may feel a bit rough from time to time as your body adjusts but persevere. Just be aware of the possibility of hypos while you are on insulin.
 

Hertfordshiremum

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385
Type of diabetes
LADA
Treatment type
Insulin
There was a definite improvement today
Yesterday’s was 14.5 on waking
Lunch. 12.5
Bedtime 9.6
That’s the lowest they’ve been in weeks
But this morning on rising it was 8.9 but when I woke in the middle of the night it was 6.4 so thanks all for the diet recommendation. I wont contact the DN for now but see if this continues over the next week . Ive plent6 of fish and meat in so ill go and buy yoghurt and berries and carrots to snack on. I cant believe I’ve been blinding accepting all the info that the DN
Has been giving me about carbs. I’m now trawling the the section on what have you eaten today to get ideas
Thanks once again for all the help
Fantastic! Justification for a c-peptide test I think. Sounds like you would need fast acting bolus insulin to eat any carbs…
 

daffy1

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10.6 this morning but going in the right direction. My mistake was eating half a dozen chestnuts last night.I didnt realise till this morning that they are very high carb. That’s a ****** cos I love chestnuts. Can I ask what about strawberry’s and grapes in small amounts if mixed in yoghurt. I worry that I won’t be eating enough fruit if I can’t eat baNNas and oranges. Which are my favourite fruit
 

KK123

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I’m another that is mystified why they are linking low b12 and iron to lack of carbs

I suspect it's because they fortify cereals etc, with iron, so when a person is identified as 'low in iron', well, it's obviously down to them not eating cereal! Talk about a warped perspective. They wouldn't give a thought to natural iron rich foods.
 

KK123

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Type of diabetes
Type 1
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10.6 this morning but going in the right direction. My mistake was eating half a dozen chestnuts last night.I didnt realise till this morning that they are very high carb. That’s a ****** cos I love chestnuts. Can I ask what about strawberry’s and grapes in small amounts if mixed in yoghurt. I worry that I won’t be eating enough fruit if I can’t eat baNNas and oranges. Which are my favourite fruit

Hi Daffy, I feel for you when you are trying to work all of this out. I'm afraid grapes in particular are like spoonfuls of sugar, in fact I sometimes use a few to get me out of a hypo. Strawberries too to a large extent, but one chopped up may be ok for you. I've read your other comments and out of all the foods you mentioned you ate (porridge, banana, bread and so on), the 2 cubes of aero was probably the best! Just to try and simplify it, as an insulin user I have to take it dependent upon what I eat, so if I eat something higher carb such as an apple, I have to take insulin for it. An innocent, healthy apple! If I were to eat a chocolate eclair (that has fewer carbs in it) then I could get away without taking insulin. I'm not suggesting you eat eclairs because obviously an apple has more nutritional value.

My point is that you should stop thinking about food as 'these items are healthy (ie nutritionally), and these ones are not'. For a diabetic who is focused on lowering glucose levels or keeping them low, then what matters is the carbs in the food not what the food is or looks like. Although you are on a low carb diet, ie under 130 per day, this does not mean that your levels won't soar if you eat a meal of 50/60 carbs. It doesn't work like that, if you eat 60g of bread or porridge you are likely to go high, the standard advice to eat no more than 50 odd carbs a meal is on the basis that it's better than a 100 carbs per meal, which the average person could easily eat in one meal.

I note you have gone onto insulin which will cause a whole other level of issues so be VERY careful about your carb intake along with insulin usage. How do you decide the amounts of insulin you use, and what are your current glucose levels when you test?
 

daffy1

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Ive been keeping to the 50g as much as I can and my sugars this morning were 8.6 which I know is still hig but much better than they have been. I’m not a morning eater and tend to eat about 10 ,am but have a couple of cups of tea. However ive just re checked my sugar b4 I eat and it’s soared to 11.5 and I’ve only had 2 cups of tea ( no sugar) how can that be. I expected it to have dropped . Please dont tell me that tea has carbs!! and I only use a small amount of semi skimmed milk. It cant possible have made me spike :(
 

catinahat

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it’s soared to 11.5 and I’ve only had 2 cups of tea ( no sugar)

Excellent, because you are no longer stuffing your body with carbs your liver has the chance to get rid of some of its stored glucose. If you don't put glucose in, your body will move it from storage where you can't see it, into your blood where you can see it and more importantly use it.