Wondering...what's next?

ichabod78

Newbie
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4
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Arrogant people.
Hi to everyone.I'm new to the forum.I was diagnosed type2 a year ago.My hba1c at the time was 8.5.They prescribed me x2 500mg metaformin daily.After cutting out sugar and cutting back on the white flour products 3months later my hba1c was 6.5,the nurse said that was bang on target and was no need to go back till after another 6 months.So in may when i last had a check up i was shocked to find out my hba1c had increased back up to 7.The nurse wasn't happy and noted i had poor control,she wanted to increase my medication but i was a bit reluctant so she said to come back in 3 months to check again.I have been doing random blood readings and they have been high between 11-15 2 hours after meals.So anyway i have to go back in september and i am worried the hba1c is going to be higher.I am wondering if anyone will know what the next step will be,meaning what will be the increase in medication?Kind regards to all.
 

Eilean13

Active Member
Messages
36
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Intolerance and closed minds
Hi Ichabod,

Welcome to the forum, its probably the most useful place you'll ever find for information. Your readings do seem high, and you've made a start with getting rid of the sugar and white flour.

My DSN (Diabetic Specialist Nurse) said to eat starchy carbs, when first diagnosed, which when I did sent the figures rocketing like you.

With the information from this forum I learned to cut out or drastically reduce not only sugar but all carbs to levels which keep me stable. So very little bread - two slices per day max, pasta and rice in very small amounts, so I made the decision to have them because it wasn't worth it. Watching the amount of fruit I eat and eating more veggies, but not grown underground ie carrots, parsnips, potatoes etc. And most importantly for me no chocolate.

I do regular testing for blood sugar levels, much to the DSN's displeasure, but at the present time, eight months from diagnosis I am running about 6.5 fairly consistently which for me is okay. When diagnosed I was 22 or 23 consistently. So much progress has been made. I don't think I could have managed it without testing as it let me see what was messing up the blood sugar.

Sounds like a lot but I worked it out a bit at a time and so far haven't found it too awful, although I do miss the chocolate. But we're all different so what works for me might not work for anyone else.

Hope this helps

Diane (aka Eilean13)
 

daisy1

Legend
Messages
26,457
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Cruelty towards animals.
Hi Ichabod and welcome to the forum :) By changing what you eat you may be able to bring your levels down without an increase in medication. It isn't enough to just cut out sugar and white flour products, you need to reduce all carby foods. When you test, take a test before the meal, then two hours after the meal. If, as you have been getting, your after-meal level is higher than your before-meal level, it means that you will have to look at what you have been eating and reduce the portion size, or even eliminate that food, until you get down to the pre-meal level. You have to do the testing as different foods affect people differently so no-one can really tell you which foods you can eat.

Here is some information which has been written for new members and I think you will find it helpful. If you have any questions then ask and someone here will have an answer for you.

BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

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 30,000 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

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes ... rains.html

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

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.
 

ichabod78

Newbie
Messages
4
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Arrogant people.
Thanks for the replies.Looks like i'm going to have to cut my carb intake even more then.I'm pretty sure my hba1c will be higher next time from the readings ive been having.So from now i'm going to be on a mission to get my readings lower!I cycle to and from work each day which is 10 miles each way.What i find is if i don't have many carbs when i get home my readings are really low(between 3-4)and it gives me a really big appetite and then i end up eating loads!So i gotta find a way to control that better.
 

viviennem

Well-Known Member
Messages
3,140
Type of diabetes
Type 2
Treatment type
Other
Dislikes
Football. Bad manners.
If you increase your fat and protein intake they'll fill you up more quickly and you'll feel fuller for longer. If you're doing "normal" cycling rather than sprint racing you shouldn't find any effect on your stamina and energy from lowering your carbs a bit more.

Having a look at my Viv's Modified Atkins Diet sticky thread at the top of the Low Carb Diabetes Diet forum on here. It may be too low carb for what you want, but if you use it as a basis and just add on a few more low GI carbs to suit you, it should be useful. Note - more carbs, less fat. I work on an 'unrestricted' fat basis, rather than 'high' fat.

It's worth a try. Happy to discuss.

Viv 8)
 

pianoman

Well-Known Member
Messages
332
Hi Ichabod and Welcome :D Please stay around, read, share and ask questions.

As above, I also try to replace carby foods (especially refined carbs) with natural fats and proteins, by focussing on real whole foods with a natural balance -- nuts and cheese for example. There is no need to starve, and I find these days that I have more stable energy (and BGs) all day even when physically active, or if I skip a meal every now and then.
 

ichabod78

Newbie
Messages
4
Dislikes
Arrogant people.
Thanks for the extra advice people.I'm noticing the results already!I cycled home at a steady pace the other night and when i got in i wasn't hungry!Just had a protein shake(only 1.3g carbs per serving)and then i was fine for the night.Checked my blood on waking this morning and it was 4.7,lowest ive had since being diagnosed. :eek: