How high evening bs 2 hours after last meal? 23.6 my highest.

Rose22

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I first had gestational diabetes ten years ago, now been told in type 2. I have felt my bs rising over past few months, and can feel when they are high. What sort of readings do most of you get at the end of a normal day?
I’ve been running 18, 16, this freaked me out as I’ve not had such high readings. Felt unwell at weekend and tested and they where 23.6 2 hours after my last meal of the day (white fish and salad) and tested an hour later dropped to 23.2 then an hour later 20.9 went to sleep or tried to! Waking bs next day was 16.0.
I’ve taken my meter reader into the drs to read off the levels and they said, yes they’re too high. (They don’t like type 2 testing impression I get, DN told me not to but I’ve carried on regardless!)
 
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EllieM

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What did your doctors say when you showed them the readings? Are they sending you for more tests? I'd expect an hba1c if nothing else.... (And, though I know T2 is most likely after GD, I'd want a cpeptide test just to check out whether T1 was a possibility.)

Otherwise - have you looked at how much carbs you are eating? Most of the T2s on here can reduce their figures by reducing their carbs.

Another thought. Though I'd regard those figures as way too high (T1 here), there are other reasons than diabetes for raised sugars, and your doctor should check them out. eg an infection can push blood sugars up, as could another pregnancy :)

Good luck. Hopefully your GP will give you a definite diagnosis. If it's T2 then I'd recommend looking at low carb options.
 
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xfieldok

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Can you tell us what you're eating in a typical day please?
 

Rose22

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Hba1c was 64 from 60 after two months on aloglptin so dr said stop taking, it’s not helping. They asked if I felt my bs running high, yes! I would only be seen once a year but it’s been me going and saying I can feel high followed by bs readings backing it up and hba1c. I’ve asked about 4 or 5 times now for the peptide or anti GAD but they refuse to do them. Say I’m type 2 and it wouldn’t effect my treatment plan, that I need take something. Currently not taking any meds. Dr said I can be referred to diabetes team which is end of Sept appointment. Before seeing them I’ve been asked to try pio..something. An older med they use less now. Couldn’t tolerate SR metformin after pharmacy gave different brand, aloglptin and lasted 1 week on Jardiance before the burning sugar wee was too much!
I tend to eat porridge with water, or eggs spinach, or Greek yoghurt nut, seeds for breakfast. Lunch/dinner tends to be family cooked meal but I don’t have the potatoes/rice etc sides. Med diet, fish meat and veggies as much as I can. I know if I have cake or something then I see it in my bs readings...or can tell high with thirst and frequent trips to loo during the day/night.
I said to dr I’ve never had such high readings! It is a concern, should I reduce my food more maybe? I’m 35 and about 10kg heavier than was few years ago, but I’m not huge.
 

Rose22

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What did your doctors say when you showed them the readings? Are they sending you for more tests? I'd expect an hba1c if nothing else.... (And, though I know T2 is most likely after GD, I'd want a cpeptide test just to check out whether T1 was a possibility.)

Otherwise - have you looked at how much carbs you are eating? Most of the T2s on here can reduce their figures by reducing their carbs.

Another thought. Though I'd regard those figures as way too high (T1 here), there are other reasons than diabetes for raised sugars, and your doctor should check them out. eg an infection can push blood sugars up, as could another pregnancy :)

Good luck. Hopefully your GP will give you a definite diagnosis. If it's T2 then I'd recommend looking at low carb options.
Thankyou for that info, very helpful! I will look at reducing my carbs more in meantime as can only help I’m sure. ☺️
 

Mbaker

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Hi @Rose22, you are very strong, when I had those numbers I remember how I felt. Your diabetes team are not falling over themselves to help you.

Your numbers are to high, but you can dramatically improve the situation. If you don't mind me being frank (please say if you do), I think you should consider a strict Whole Foods Ketogenic lifestyle on maximally 2 meals a day. The benefits are that both fasting and post prandial blood glucose would lower and you would reduce other risks. I will stop at this point in case this is not your preferred route.
 
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Antje77

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I agree with @EllieM , push for additional testing. Also, should you start feeling sick, nauseous or get a stomach ache with high numbers, go to a+e. Many adult onset T1's had gestational diabetes first.
Apart from the porridge and possibly the yoghurt you diet doesn't sound very high carb, but if you can cut them further it may help.
Good luck, and let us know how things develop!
 

kitedoc

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Not as medical advice or opinion:
Ask your doctor to test you for ketones.
Not first thing in the morning but say after lunchtime. Go in tomorrow and ask the nurse to do sonald let the GP know.
A high blood ketone reading in association BSL > 13 mmol/l is dangerous. And going to hospital is required in such a case. blood glucose meters can test for blood ketones with special strips from the chemist. You would need to see whether your meter can do this if you cannot access GP or nurse for some daft reason.
I know that Freestyle and Contour Next meters can but not sure about other brands.
There is no excuse for your doctor not to have the wherewithall to do this test also. Urine testing for ketones is second best.
Your GP should have done this as routine for anyone with the high levels of BSL you have been experiencing.

If you feel nauseaous, have stomach pains and cannot check ketones easily and quickly bypass your GP and head to A&E as soon as you can.
You could also ask your GP to ring a endocriniologist like the one you have been booked to see in an unacceptable time in the future, to ask for advice on your case. If he refuses you can say you will be reporting him.
Seeing another GP is always an option to obtaining better service.
 

Cobia

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Hba1c was 64 from 60 after two months on aloglptin so dr said stop taking, it’s not helping. They asked if I felt my bs running high, yes! I would only be seen once a year but it’s been me going and saying I can feel high followed by bs readings backing it up and hba1c. I’ve asked about 4 or 5 times now for the peptide or anti GAD but they refuse to do them. Say I’m type 2 and it wouldn’t effect my treatment plan, that I need take something. Currently not taking any meds. Dr said I can be referred to diabetes team which is end of Sept appointment. Before seeing them I’ve been asked to try pio..something. An older med they use less now. Couldn’t tolerate SR metformin after pharmacy gave different brand, aloglptin and lasted 1 week on Jardiance before the burning sugar wee was too much!
I tend to eat porridge with water, or eggs spinach, or Greek yoghurt nut, seeds for breakfast. Lunch/dinner tends to be family cooked meal but I don’t have the potatoes/rice etc sides. Med diet, fish meat and veggies as much as I can. I know if I have cake or something then I see it in my bs readings...or can tell high with thirst and frequent trips to loo during the day/night.
I said to dr I’ve never had such high readings! It is a concern, should I reduce my food more maybe? I’m 35 and about 10kg heavier than was few years ago, but I’m not huge.


Push harder for the antigad and cpeptide tests.... the hospital i was diagnosed at said i was t2 just because of age. 46 full on dka and i was a walking skeleton losing sight every min and they never tested me... i got the tests 6 months later.

Doesnt hurt to know.
 

Rose22

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Thankyou for your advice, it’s great to hear from others who know from their own experiences with diabetes rather than a diabetes nurse who tells me something different every time I see them. Often leaving me more confused and down hearted than before.
Thanks Antje77 I will watch out of any sudden symptoms like that, thanks for your help. Will let you know what happens over next few weeks.
MBaker, do you mind me asking how you felt when you started fasting? I can see you are in remission, very well done to you, that must’ve taken massive effort! I have been worried about fasting, as I usually go a bit shaky and feel pretty yuk if I don’t eat. Do you find you have enough energy to still be fairly active and exercise? I have children and want to be able to walk/run/cycle with them each day to school and back as I do now. (Well apart from days feel nauseous or like my legs are too weary, seems to be a day of feeling good followed by few of not).
Do you mind me asking what sort of numbers you have most of the time 2 hours after meal?
I’d be happy with 6-10 again! ☺️
 
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Rose22

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282
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Not as medical advice or opinion:
Ask your doctor to test you for ketones.
Not first thing in the morning but say after lunchtime. Go in tomorrow and ask the nurse to do sonald let the GP know.
A high blood ketone reading in association BSL > 13 mmol/l is dangerous. And going to hospital is required in such a case. blood glucose meters can test for blood ketones with special strips from the chemist. You would need to see whether your meter can do this if you cannot access GP or nurse for some daft reason.
I know that Freestyle and Contour Next meters can but not sure about other brands.
There is no excuse for your doctor not to have the wherewithall to do this test also. Urine testing for ketones is second best.
Your GP should have done this as routine for anyone with the high levels of BSL you have been experiencing.

If you feel nauseaous, have stomach pains and cannot check ketones easily and quickly bypass your GP and head to A&E as soon as you can.
You could also ask your GP to ring a endocriniologist like the one you have been booked to see in an unacceptable time in the future, to ask for advice on your case. If he refuses you can say you will be reporting him.
Seeing another GP is always an option to obtaining better service.

Oh ok thankyou, when I was given jardiance to take it came with a page on DKA risk, and said about ketones, but I wasn’t told to test or given any test strips? I only lasted one week on that med! Awful side effects! You pee out huge amounts of sugar! Every 1/2 an hour in my case! I have a OneTouch plus easy I think it is? Had it from 5 years ago when pregnant with my daughter. I ended up needing insulin with her and kept the machine and buy my own strips to test now. (The nurse doesn’t like it, they tell you not to test) it doesn’t test ketones as far as I know. I could get some urine ones from pharmacy I think.
They sent a letter a few months ago as one dr I saw quieried if I was type 2, as first had gestational when I was 25 years old, then again 30 then I kept it in prediabetic range for 3 years, now sudden fast increase in levels. They replied saying could see on a website, an Exeter one? I can access my records online and read the letters and see test results. I did it and it showed 60 percent chance, dr did it and showed 7 percent! How can there be such a discrepancy? I said I did use insulin and I do have parent with type 2 and grandmother with type 1. But they said it didn’t show the same result so they wouldn’t do the test. We pretty much argued over it for 20 minutes. I am saying I’d rather you do test see what’s happening then treat, rather than just keep trying various meds whilst I have to have the side effects, need feel well. I’ve asked different drs in my surgery including the diabetes nurse, all drs said no and nurse said to try do it privately? I’m hoping when see diabetes team in my local hospital that they can be of more help! I might try see directly with the hosp if can bring appoint forward. End sept is the standard 3 months wait.
When I was first told had gestational ten years ago the care was much better. When I went in to drs on Mon after the weekend of high readings in 20s which I’ve not had before, I took my reader in and showed the latest figures, as can go through the memory. She asked did I feel they where too high? Yes most definitely! She didn’t test me then or mention ketones. She saw I had appoint end of Sept with diabetes team and said she would call me after speaking to another dr. She said on phone to get a prescription for Pioglitazone. To take it and re test hba1c in 3 months...I haven’t started taking it yet as she said it may cause weight gain water retention.
 

Rose22

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Push harder for the antigad and cpeptide tests.... the hospital i was diagnosed at said i was t2 just because of age. 46 full on dka and i was a walking skeleton losing sight every min and they never tested me... i got the tests 6 months later.

Doesnt hurt to know.
Oh my goodness! You must’ve felt so unwell by then. Hopefully you have a good level of care now properly diagnosed!?
 

kitedoc

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Doctors i think lose their ability to think when applying guidelines and as you say they seem to not even be able to use a risks calculator properly.
Anyone with a high bsl is entitled to have a blood ketone measured on a meter but that also requires a competent nurse and doctor, not guideline-driven technicians.
You may need resort to urine strips to check ketones or be prepared to buy a meter which does BSLs and ketone plus the ketone strips and find a better doctor. ASAP....
As others have said yours in not an uncommon scenario with the risk of calamitous events to follow sometimes.
So please push for a new doc and even if it has to be seeing a new nurse at the new surgery first with your results or if in doubt head to the nearest A&E and tell your story, of your results and of your concerns about lack of proper medical support.