- Messages
- 4,245
- Type of diabetes
- Type 2
- Treatment type
- Tablets (oral)
- Dislikes
-
Diet drinks - the artificial sweeteners taste vile.
Having to forswear foods I have loved all my life.
Trying to find low carb meals when eating out.
Warning! Long post!
For a few years i have been following(ish) LCHF. Not massively strictly, but generally not many refined carbohydrates and mainly protein, fat and vegetables. Occasional BG tests looked reasonable, and Ketone testing showed that I was generally in ketosis at around 1.9.
At my annual review on 18th September 2018 my DSN said that because of my excellent control (HbA1c of 6.4%) I should consider cutting back on the Metformin from 3 * 500mg to 2. This because my eGFR is low and Metformin doesn't help kidney filtration.
I wasn't quite as enthusiastic at describing 6.4% as excellent control but I assume that compared to others it wasn't too shabby.
Cue a confusing few months, with lots of personal upheaval, where I cam completely off Metformin to give myself a true baseline and where I couldn't get an HbA1c test when I was near my local surgery because I was within the 3 month window since my last test and so resorted to using A1CNow home test kit.
On 14/12/2018 this gave me a result of 64 mmol/mol or 8.0%.
Immediately back on the 3 * 500mg Metformin, and a resolution to cross check the A1CNow test result against a standard blood draw next time I had a test.
I thought I was back on the rails again, and when I had blood drawn on 7/5/2019 I also tested using A1CNow and got a result of 43 mmol/mol or 6.1% which was very cheering.
However over the weekend I got a call from the surgery wanting me to make an appointment to come in and see them a.s.a.p.; I would normally have had an appointment already set up but our long term DSN had just moved away from the practice and there wasn't a replacement. Getting back from my weekend away I checked my latest results on line and my HbA1C was 7.2% or 55.2 mmol/mol. This was a shock, to say the least! This equates to an average finger prick test of 8.9 mmol/L.
Up to that point I had thought that I could "cheat" a little with the occasional piece of bread or a roll, or something else a bit carby, because my overall carbohydrate intake was still low in the great scheme of things.
My first testing started with a reading of 5.3 at 14:00 after having bullet resistant coffee at 08:30.
That looks pretty normal.
Had a Waitrose pain rustique brown roll with three chipolata (99% pork) sausages.
Two hours later, 10.9. What?
Three hours later, 10.1. Double What?
Four hours later, after riding my bike around for a bit setting up a new saddle it was down to 6.1. However 4 hours to come back down? Something not right.
Next day FBG 8.6.
Nearly 3 hours later, still fasting, 8.2.
2.5 hours after BPC it was down to 6.5.
Sipping beer (well, weekend away) and a couple of hours later it was up to 7.1.
Sausages without the roll and two hours later 7.3.
So (obviously) it was the roll.
Evening meal - didn't test before hand but 2 hours after a lasagne with salad BG was 8.1 (I assume that it started around the 7 mark).
Monday; FBG 7.8, 4.5 hours later after BPC down to 6.6. This test just before I ate.
Half a Waitrose white roll with pate.
2 hours later 11.6.
3 hours after eating 7.4. About to eat evening meal.
2 hours after steak and tomatoes down to 6.3.
What this seems to illustrate is that I have far less tolerance of refined carbohydrates, especially bread, than I fondly thought. However I do seem to cope reasonably well with lowish carbohydrate meals such as lasagne.
Oh, and I tested my ketones and they came back 0.5 so I'm not really in ketosis at the moment.
From this short and scary bit of testing I conclude that I shouldn't be complacent and allow myself little treats but I should redo some food testing to see what works for me now.
I think my first aim should probably be to get back into dietary ketosis and get rid of the glucose store which (I assume) is keeping my background BG up in the 6s and 7s.
Noting that my last good HbA1c at 6.4% equated to an average finger prick test of 7.6 so perhaps I have been running at this level in the past and failing to match the HbA1c to average finger prick test.
Anyway, they have a locum DSN visiting occasionally and I am booked in next week for a chat.
Meanwhile I need to get my BG under much better control. I might have a short fast to see if I can kick start ketosis, as well.
The most disappointing aspect is that the A1CNow test was nowhere near the laboratory test. Others have found them good, and I can't be certain that I did the test exactly right although the meter reported that the test was OK. I was hoping to use this perhaps 3 monthly just to keep an eye on things, but it is very expensive to test against the laboratory results and I don't fancy bulk buying if the product isn't any good.
Edit: forgot to say that I weigh myself every day and my weight has been stable although slightly higher than I would wish. I assumed that no weight gain meant no surplus carbohydrates to turn into fat. I also assumed that because I could ride 20 miles on just coffee, cream and butter that I was long term keto adapted. Complacent.
For a few years i have been following(ish) LCHF. Not massively strictly, but generally not many refined carbohydrates and mainly protein, fat and vegetables. Occasional BG tests looked reasonable, and Ketone testing showed that I was generally in ketosis at around 1.9.
At my annual review on 18th September 2018 my DSN said that because of my excellent control (HbA1c of 6.4%) I should consider cutting back on the Metformin from 3 * 500mg to 2. This because my eGFR is low and Metformin doesn't help kidney filtration.
I wasn't quite as enthusiastic at describing 6.4% as excellent control but I assume that compared to others it wasn't too shabby.
Cue a confusing few months, with lots of personal upheaval, where I cam completely off Metformin to give myself a true baseline and where I couldn't get an HbA1c test when I was near my local surgery because I was within the 3 month window since my last test and so resorted to using A1CNow home test kit.
On 14/12/2018 this gave me a result of 64 mmol/mol or 8.0%.
Immediately back on the 3 * 500mg Metformin, and a resolution to cross check the A1CNow test result against a standard blood draw next time I had a test.
I thought I was back on the rails again, and when I had blood drawn on 7/5/2019 I also tested using A1CNow and got a result of 43 mmol/mol or 6.1% which was very cheering.
However over the weekend I got a call from the surgery wanting me to make an appointment to come in and see them a.s.a.p.; I would normally have had an appointment already set up but our long term DSN had just moved away from the practice and there wasn't a replacement. Getting back from my weekend away I checked my latest results on line and my HbA1C was 7.2% or 55.2 mmol/mol. This was a shock, to say the least! This equates to an average finger prick test of 8.9 mmol/L.
Up to that point I had thought that I could "cheat" a little with the occasional piece of bread or a roll, or something else a bit carby, because my overall carbohydrate intake was still low in the great scheme of things.
My first testing started with a reading of 5.3 at 14:00 after having bullet resistant coffee at 08:30.
That looks pretty normal.
Had a Waitrose pain rustique brown roll with three chipolata (99% pork) sausages.
Two hours later, 10.9. What?
Three hours later, 10.1. Double What?
Four hours later, after riding my bike around for a bit setting up a new saddle it was down to 6.1. However 4 hours to come back down? Something not right.
Next day FBG 8.6.
Nearly 3 hours later, still fasting, 8.2.
2.5 hours after BPC it was down to 6.5.
Sipping beer (well, weekend away) and a couple of hours later it was up to 7.1.
Sausages without the roll and two hours later 7.3.
So (obviously) it was the roll.
Evening meal - didn't test before hand but 2 hours after a lasagne with salad BG was 8.1 (I assume that it started around the 7 mark).
Monday; FBG 7.8, 4.5 hours later after BPC down to 6.6. This test just before I ate.
Half a Waitrose white roll with pate.
2 hours later 11.6.
3 hours after eating 7.4. About to eat evening meal.
2 hours after steak and tomatoes down to 6.3.
What this seems to illustrate is that I have far less tolerance of refined carbohydrates, especially bread, than I fondly thought. However I do seem to cope reasonably well with lowish carbohydrate meals such as lasagne.
Oh, and I tested my ketones and they came back 0.5 so I'm not really in ketosis at the moment.
From this short and scary bit of testing I conclude that I shouldn't be complacent and allow myself little treats but I should redo some food testing to see what works for me now.
I think my first aim should probably be to get back into dietary ketosis and get rid of the glucose store which (I assume) is keeping my background BG up in the 6s and 7s.
Noting that my last good HbA1c at 6.4% equated to an average finger prick test of 7.6 so perhaps I have been running at this level in the past and failing to match the HbA1c to average finger prick test.
Anyway, they have a locum DSN visiting occasionally and I am booked in next week for a chat.
Meanwhile I need to get my BG under much better control. I might have a short fast to see if I can kick start ketosis, as well.
The most disappointing aspect is that the A1CNow test was nowhere near the laboratory test. Others have found them good, and I can't be certain that I did the test exactly right although the meter reported that the test was OK. I was hoping to use this perhaps 3 monthly just to keep an eye on things, but it is very expensive to test against the laboratory results and I don't fancy bulk buying if the product isn't any good.
Edit: forgot to say that I weigh myself every day and my weight has been stable although slightly higher than I would wish. I assumed that no weight gain meant no surplus carbohydrates to turn into fat. I also assumed that because I could ride 20 miles on just coffee, cream and butter that I was long term keto adapted. Complacent.
