**** it [emoji22]

[Mantre]

2nd anniversary review and bloods have gone from 54 to 62! Thought I was doing so well with diet etc so to this news was kind of a kick in the teeth. Nurse has now told me to write a 3 month food diary and now take readings 2 times a day as don’t really know what’s going on. Got to go back in 3 months for more bloods etc. Any sensible advise....don’t say the 600/800 calorie diet will work as ask my nurse today and she said No No No!!

 

[bulkbiker]

What have you been eating?
The food diary is a good idea,, cutting down on carb consumption almost always leads to lower blood sugars and maybe try some meal skipping to reduce insulin triggering.

 

[JoKalsbeek]

2nd anniversary review and bloods have gone from 54 to 62! Thought I was doing so well with diet etc so to this news was kind of a kick in the teeth. Nurse has now told me to write a 3 month food diary and now take readings 2 times a day as don’t really know what’s going on. Got to go back in 3 months for more bloods etc. Any sensible advise....don’t say the 600/800 calorie diet will work as ask my nurse today and she said No No No!!

Taking readings twice a day isn't really going to tell you anything. You want to check before a meal and 2 hours after. if there's a rise of more than 2.0 mmol/l, the meal was carbier than your body could handle. And practically all carbs turn to glucose when ingested. Knowing that, what has your diet been like? Carb-heavy? Because for T2's, bread, potatoes, pasta, corn, cereal/muesli, rice, and anything made with grain, will spike our bloodsugars. (And no, it doesn't matter if you switch from white bread to brown. Your pancreas will still have to deal with the carbs, whatever their colour.). So, nope, not going to tell you the 600/800 calorie diet will work, because it won't. You want to cut the carbs and load up on fat instead. It'll keep you feeling full, while not spiking your bloodsugars at all. So... If you're into 3 meals a day, go for eggs wih bacon and cheese, maybe high meat content sausages and the like in the morning. No toast, no beans. For lunch, a nice tuna, salmon or goat cheese salad? For dinner, meat with leafy greens or other above ground veggies? I rather like cauliflower and broccoli rice, they're rather versatile and I dump cheese and bacon in there to bulk it up some. Never have spuds, and don't miss them either. You don't have to go hungry on this det because it is one you'll have to be on for life, to control your bloodsugars.

That said, don't go low carb if you're on gliclazide or insulin, because you'll hypo. (Another member just found that out the hard way.). Discuss the steps you want to take with a doc first and go from there, and test like there's no tomorrow.

Good luck!
Jo
PS: You might want to read Dr. Jason Fung's the Diabetes Code, www.dietdoctor.com, this forum's website and my own blogposy: https://www.diabetes.co.uk/forum/blog-entry/the-nutritional-thingy.2330/

 

[First.Officer]

As has been said above regarding carbs, fats etc.....personally i wouldn't read too much in to this whole "don't spike more than 2 mol/mmol" stuff - i know it's been stated in some report somewhere (can't recall where now) but its generally rubbish as most non-diabetics and diabetics with good control will spike more than that ordinarily, depending on carb./sugar intake and without overtly affecting their HbA1c when tested. In fact there are reports of study groups of individuals tested whom have definitively not got any kind of endocrine disorder whatsoever, and yet post-prandial spikes were observed of up to 9.3 mol/mmol.

 

[JoKalsbeek]

As has been said above regarding carbs, fats etc.....personally i wouldn't read too much in to this whole "don't spike more than 2 mol/mmol" stuff - i know it's been stated in some report somewhere (can't recall where now) but its generally rubbish as most non-diabetics and diabetics with good control will spike more than that ordinarily, depending on carb./sugar intake and without overtly affecting their HbA1c when tested. In fact there are reports of study groups of individuals tested whom have definitively not got any kind of endocrine disorder whatsoever, and yet post-prandial spikes were observed of up to 9.3 mol/mmol.

....That "stuff" fixed my complications. Got my fasting bloodglucose down. But hey, whatever.

 

[pavlosn]

Eating to your meter, testing before and two hours after a meal, keeping the after count within 2 mmol of the before count, relating your result back to the carb count of your meal by possibly keeping a diary, and adjusting level of carbs in the next meal until you can achieve is in my personal experience the best advise you can give to someone wishing to gain control over their glucose levels.

It is an easy rule to remember. It provides immediate feedback and allows for rectifying action thus empowering the individual to regain control.

Trying to control fasting blood glucose is much harder to do and far less reliable because of the dawn syndrome, our body naturally increasing glucose levels to provide for expected energy needs of the coming day.

In my experience once you consistently hit the 3 mmol post prandial increase target then fasting blood glucose also eventually reduces.

So irrespective of whether non diabetics have post prandial peaks of more than 2 mmol of their pre meal counts, the 2 mmol rule is still an invaluable tool towards regaining glycemic control in my opinion

 

[Marie 2]

What I always want to warn people is that if you are doing everything right and it doesn't make sense, you could be a misdiagnosed type 1. Too many type 1/LADA's are misdiagnosed as type 2's because it develops over years, sometimes 8 years or more. You make some insulin until you don't. So your numbers will slowly just keep getting worse no matter how well you eat as you make less and less insulin. Just keep it in mind, just in case.

 

[Gryph]

As has been said above regarding carbs, fats etc.....personally i wouldn't read too much in to this whole "don't spike more than 2 mol/mmol" stuff - i know it's been stated in some report somewhere (can't recall where now) but its generally rubbish as most non-diabetics and diabetics with good control will spike more than that ordinarily, depending on carb./sugar intake and without overtly affecting their HbA1c when tested. In fact there are reports of study groups of individuals tested whom have definitively not got any kind of endocrine disorder whatsoever, and yet post-prandial spikes were observed of up to 9.3 mol/mmol.

Edit to add... TL;DR - a spike in BG will impact your hba1c. How many and how high is entirely up to you, your BGM may help

That’s a very interesting response. Please take the time to link the studies or accompanying data so that we may review?

From my own data of BG testing I can categorically say that keeping to a rule of ‘no more than 2.0 rise’ has worked wonders.

When I have my hba1c test a week on Friday, I will publish the results, along with the MySugr app which has been recording everything.

I’m on holiday at the moment, and trying a few different things, and where I have had a low number unfortunate spikes of 3+, they do impact the overall predicted hba1c. Of course they do, if you go 4, 4, 5, 4, 5, 5, 6, 5 regularly (FBG, 3 meals, final BG) and start throwing in spikes to [whatever] 8, the average will change.

Case in point. Dinner out tonight, I’m 4.4 BG according to meter, my wife is 5.0. She does not have T2D. 45 minutes after first bite, I’m 7.4, she is 5.2. Two hours post, I’m 5.4 and she is 5.0. Taking into account error margins, clearly shows the food was a challenge for me.

We split the entire dinner between us; ate and drank the same.

That for me was not ideal, and will have increased my hba1c. I suspected as much as I wanted a little rice with our Thai feast. My levels have been low to this point, so was prepared to take the hit.

This spike will increase my hba1c reading. Keep doing it and it will increase. Keep at it and watch the levels hit T2D again...

Apologies to OP that I’ve hijacked this a little, but couldn’t let that comment stand unchallenged.

 

[pavlosn]

I would be perfectly happy with the numbers you quote for the "challenge" food. As far as I am concerned a post prandial reading of 5.4 at two hours is a perfectly acceptable non diabetic response.
So what if there is a small rise in A1C from say 34 to 36. Would that be of any real significance?

Edit to add... TL;DR - a spike in BG will impact your hba1c. How many and how high is entirely up to you, your BGM may help

That’s a very interesting response. Please take the time to link the studies or accompanying data so that we may review?

From my own data of BG testing I can categorically say that keeping to a rule of ‘no more than 2.0 rise’ has worked wonders.

When I have my hba1c test a week on Friday, I will publish the results, along with the MySugr app which has been recording everything.

I’m on holiday at the moment, and trying a few different things, and where I have had a low number unfortunate spikes of 3+, they do impact the overall predicted hba1c. Of course they do, if you go 4, 4, 5, 4, 5, 5, 6, 5 regularly (FBG, 3 meals, final BG) and start throwing in spikes to [whatever] 8, the average will change.

Case in point. Dinner out tonight, I’m 4.4 BG according to meter, my wife is 5.0. She does not have T2D. 45 minutes after first bite, I’m 7.4, she is 5.2. Two hours post, I’m 5.4 and she is 5.0. Taking into account error margins, clearly shows the food was a challenge for me.

We split the entire dinner between us; ate and drank the same.

That for me was not ideal, and will have increased my hba1c. I suspected as much as I wanted a little rice with our Thai feast. My levels have been low to this point, so was prepared to take the hit.

This spike will increase my hba1c reading. Keep doing it and it will increase. Keep at it and watch the levels hit T2D again...

Apologies to OP that I’ve hijacked this a little, but couldn’t let that comment stand unchallenged.

 

[Gryph]

As has been said above regarding carbs, fats etc.....personally i wouldn't read too much in to this whole "don't spike more than 2 mol/mmol" stuff - i know it's been stated in some report somewhere (can't recall where now) but its generally rubbish as most non-diabetics and diabetics with good control will spike more than that ordinarily, depending on carb./sugar intake and without overtly affecting their HbA1c when tested. In fact there are reports of study groups of individuals tested whom have definitively not got any kind of endocrine disorder whatsoever, and yet post-prandial spikes were observed of up to 9.3 mol/mmol.

Returning to your post, I’m sure that I read somewhere that over 7.8 (can’t recall exact 7. Something number) BG and beta cells are negatively affected.

This is the crux of my previous post I guess. Personally, I don’t want to hit that at any point.

I’m currently searching the forum on and off to find the link, when I do find, I’ll post it (or claim to have imagined it).

Apologies if I came across a little abrupt... it was not intended.

 

[Resurgam]

2nd anniversary review and bloods have gone from 54 to 62! Thought I was doing so well with diet etc so to this news was kind of a kick in the teeth. Nurse has now told me to write a 3 month food diary and now take readings 2 times a day as don’t really know what’s going on. Got to go back in 3 months for more bloods etc. Any sensible advise....don’t say the 600/800 calorie diet will work as ask my nurse today and she said No No No!!

Oh dear - with that sort of advice, I don't see you getting very far.
Testing twice a day - the best thing (for you) would be to test just before starting to eat a meal and then two hours after that time. If the meal has pushed your blood glucose level up more than two whole numbers evaluate the carbs it contained and consider what to change to something lower in carbs. Maybe start in the morning, as diabetics are often more carb resistant then, so changes will have more effect, but once you are getting good readings at breakfast, move to testing another meal.
If you are rather overweight then the Newcastle diet might be just the thing for you - there are some horror stories about nurses on the forum - I do sometimes wonder what their aim is in life. You could try eating just twice a day (it suits me absolutely) and eating low carb has sorted out my Hba1c, and my day to day blood glucose levels as well. There are lots of regimes to try - but not making changes seems - to my way of thinking - wasting time.