Diagnosed and confused.

[OU812]

It sounds like an HbA1c in that case. What did it say on the requisition form? Can you remember?

I found the one I have to do in 3 months and your right it's hemoglobin a1c.

 

[OU812]

Test immediately before you eat
Test again 2 hours after first bite

Then I found this.


https://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html

So is it 2 hours or 90 mins?

 

[Tophat1900]

Wow, you have received some horrendous advice on testing from so called professionals.

I'd follow the advice you have been given on here in regards to testing and testing times.

 

[daisy1]

@OU812

Hello 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 want 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.
  

 

[Bluetit1802]

The reason we say test 2 hours after first bite is because that time is the only one we have recommended targets for. By 2 hours we should be well on our way down from our peak. Depending on what we eat, we would normally expect to peak somewhere between an hour and 90 minutes, so if you have plenty of strips and are interested in catching your peaks, you can try testing at an hour, at 90 minutes, and at 2 hours. You can also keep testing after the 2 hour mark to see how long it takes to get back where you started. It is entirely up to you, but whatever you do it is wise to write all these down in a structured way so you can learn from it. You should also note that some meals/foods take a lot longer to digest, so you may see more than one spike - and the second may be after the 2 hour mark. It is not an exact science.

 

[OU812]

The reason we say test 2 hours after first bite is because that time is the only one we have recommended targets for. By 2 hours we should be well on our way down from our peak. Depending on what we eat, we would normally expect to peak somewhere between an hour and 90 minutes, so if you have plenty of strips and are interested in catching your peaks, you can try testing at an hour, at 90 minutes, and at 2 hours. You can also keep testing after the 2 hour mark to see how long it takes to get back where you started. It is entirely up to you, but whatever you do it is wise to write all these down in a structured way so you can learn from it. You should also note that some meals/foods take a lot longer to digest, so you may see more than one spike - and the second may be after the 2 hour mark. It is not an exact science.

That makes sense. I did my first post meal test last night at 2 hours and I was 5.9.

 

[david1968]

@OU812

To back up what bluetit advsies. I keep a food diary. It invololes a bti of planning and measuring but I can see what I ate (and how much) and what impact it has.

As an example a few weeks back, I decided to "test" weetabix - a nice healthy breakfast - to see if I could eat them. Before eating BG was 5.9, ninety (90) mins after it was 7.6 and then dropped to 5.1 after 2 hours. Without the diary I wouldn't be able to look back and see the impact of various foods.

I'd agree with keeping a food diary as well as testing your bg and noting that in your food diary as well.

To illustrate the differences the same food can have on people, I was getting much bigger increases than @ixi1429 eating weetabix - in my case my readings were 3 or 4 whole points higher than my readings before eating so much as I like weetabix, it had to go.

 

[TheBigNewt]

That makes sense. I did my first post meal test last night at 2 hours and I was 5.9.

That's pretty close to normal IMO. Sounds like you don't have a big problem going here now.

 

[paulus1]

depends what they ate

 

[OU812]

Did another one last night and was 6.1.

 

[Granny_grump_]

Some people test at 90 mins after eating but the majority consensus is 2 hours, if you are trying to find what spikes your BG and it's something you haven't tested out you can then test 90 mins and every half hour until you find out how long it takes for your BG to return to normal range after you've eaten it . It's called eating to your meter,if BG is higher than it should be after eating something you haven't tested out before it's the only way you can work out what foods spike you and what keeps your BG on an even keel,it's the spikes that do the damage.K

 

[OU812]

Apologies if this isnt the right place to post all this but I didnt want to spread stuff everywhere:

Since I joined I have dropped from about 230 pounds down to 212 pounds

So I have been doing readings for a while now and have noted something that I cannot explain and am hoping for some insight:

Between Feb 15 and Mar 18 after fasting my readings ranged from a low of 3.9 (in 3's only once) to 6.8 for this same time period 2 hours after eating range was 4.4 to 6.8.

Starting Mar 19 my fasting numbers have ranged have had been from 7.0 to 8.5 many times (10 different days) 2 hours after meals have always been between 4.3 and 8.0.

As far as I can tell a large percentage of days I am falling in the "normal" range but the spikes outside (*which I have only seen on fasting) concern me.

I have looked online and seen several mentions of at dawn syndrome as well as Somogyi effect. It seems that Somogyi is not common to T2, (maybe its my luck).

My 3 month average testing date is getting close so hopefully that will provide more detail.

Appreciate any thoughts.

 

[catapillar]

I have looked online and seen several mentions of at dawn syndrome as well as Somogyi effect. It seems that Somogyi is not common to T2, (maybe its my luck).

The symogi effect refers to going hypo and then bouncing up to a high blood sugar because your body has reacted to the hypo.

Are you on any medication that would cause hypos? If not, it's highly unlikely you are having any symogi.

On the 10 days when you've had high fasting readings is there any correlation to being stressed - stressful days at work the day before or coming up? Stress can raise your blood sugar. Or poor sleep, bad sleep can raise your blood sugar. Or high carb meals the night before, the effect of a high carb meal can linger. Or no alcohol the night before, alcohol keeps your liver busy, so can stop the release of glucose in the morning that causes the dawn phenomenon.

 

[OU812]

Thanks for the reply.

I have a stressful life in general, 5 year old twins and a special needs child as well. I am also a shift worker in a stressful position so my sleep and dietary intake are in constant flux. The only med I take is metformin. I am supposed to take 2 a day but with where my numbers have been my pharmacist suggested staying at 1 a day.

I would have to look deeper and correlate to my shift times etc.

No alcohol since NYE. I did have a small pizza last night and had an 8.0 this am and was about 12 hours removed from eating.

 

[Freema]

the green area is the normal non diabetic levels, you seem to be doing really fine
https://ketodietapp.com/Blog/category/Recipes?page=1

 

[Alexandra100]

The only med I take is metformin. I am supposed to take 2 a day but with where my numbers have been my pharmacist suggested staying at 1 a day.

Sadly, I am not at all qualified to disagree with your pharmacist, but I'm going to do it anyway. It is said that Metformin has no effect until the dose has been increased to 2000mg. So reducing it to 500mg probably makes taking it at all pointless. Metformin is a pretty harmless drug with a long pedigree, having been prescribed for decades. It has various helpful side effects as well as helping lower bg (though not nearly as much as a low carb diet). Unless a person suffers bad and persisting digestive problems in reaction to Metformin, or unless s/he has achieved totally perfect bg levels, why would anyone stop taking it? And yet people talk about "Getting off Metformin" as if it were heroin.

I like this article by a former contributor to this Forum: http://www.mendosa.com/blog/?p=1261

I am currently listening to podcasts of some past phone-ins with the great Dr Bernstein. He repeats over and over his principle, that what counts is achieving normal bg. If I can get even a little nearer to a normal bg by taking a benign pill twice a day, I'm going to do it.

 

[Stronggirlsclub]

I started off testing before and after eating, but once I reduced carbs enough to be below 8mmol/l after eating then I stopped testing so often - and I only eat twice a day, so with being pretty sure that my first meal is not going to cause problems as it is lower in carbs than dinner, I was just testing to see if I could eat a dessert, and gradually stopped bothering as I was seeing after dinner readings of below 7 then below 6.

How long did it take before you saw your numbers drop with LCHF?

 

[Resurgam]

How long did it take before you saw your numbers drop with LCHF?

I stopped eating carbs for about 30 hours from the moment I was informed of the diagnosis, so by the time I got the meter sorted out I was already dropping down below 10mmol/l.