T2 diabetic - Can't lower my blood test below 9.0

[donnyguy59]

I work night shifts so my sleeping pattern is all over the place. If I test two hours after after main evening meal, before going to work, my finger prick test readings are nearly always over 18 mmol/l. My next meal is lunch around 2pm following day after getting home and going straight to bed. Before I eat, my readings are still over 9. I've even tried fasting, just having the main meal once a day with no snacking but the readings are still between 8 and 10. I always feel tired and lethargic, sometimes with headache. I'm on max dose of Metformin, so what's happening and whats next step in treatment options?

 

[Bluetit1802]

Perhaps you could tell us what you eat in a typical day. It could be your food choices that are causing this. Maybe we can spot something.

 

[Norfolkmell]

Hi and welcome.
Really good that you are testing, are you recording what you are eating along with your BGs? And how long since you are diagnosed? You will find that some of us on here got spectacular results early on and some like me are plodders. My GP described me as a successful tortoise on LCHF, in three and half years I've gone from I think 68 to 48 but have lost seven and half stone only LCHF 90% of the time and sticking to between 80 and 100 g of carbs a day. My BG can go from 5 to 10 plus on some days and other days can just rocket sometimes with eating something that didn't spike me the last time I ate it.
I spent several years pre diagnosis trying to lose weight but once I'd lost some after paying out for diet classes every week it just went back. The weight has consistently gone down even with my hba1c having leapt up for a couple of times. I do have numerous other conditions which don't don't help and stress doesn't either.
You have come to the right place for help and support, and you will find that all of us will have different journeys, most of us LCHF but in vastly different approaches and lifestyles. I could not fast unless I was asleep for 24 hours, I get grumpy, stressed and washed out if I don't eat often. I don't sleep very well never have done and have been known since diagnosis to be roaming about in the middle of the night needing to eat something because the last time I ate was 3-5 hours before going to bed so I make sure I've had something usually berries and cream before I go to bed. My beloved also gets grumpy if I get up in the night as I have to wake him to actually get out of bed. I also struggle if I haven't had enough to drink during the day and sometimes I've just been doing something and forgotten or mostly because I'm having a bad day mobility wise and haven't physically been able to make myself a drink and have to wait until my beloved gets home from work.
So it could be all manner of things but I recommend recording what you've eaten and when alongside of your BG results will help.

 

[donnyguy59]

Regarding my average 8-10 mmol/L... over xmas i was at a party. ten of us all tested using finger prick test before we started eating and drinking., everyone except me was below 6.5, I was 15.9... later on, a couple of hours after end of food scoffing and beer guzzling we all tested again. Everyone except me was below 7 but I was 28.9 !!! yes 28.9 mmol/L. a nights sleep and a retest 12hrs after the last one, before eating anything, the reading was still up at 19.8. Will have to sort my diet!

 

[VashtiB]

Hi Donnyguy,

What sort of things are you eating at the moment. Those are really high readings. I am surprised that you were happy to do lots of 'food scoffing and beer guzzling' when you were already so high.

Have you tried going low carb for any time? While I find that intermittent fasting or one meal a day can help it doesn't help if that one meal has too high carbs.

I would be concerned about the amount of carbs in beer for example- I think there are some low carb beers but I'm not a beer drinker so don't really know.

There is still a lot you can eat doing low carb and I really really recommend that you try it for a couple of weeks and see what effect it has on your levels.

If I had your levels I would be concerned about the possible damage that the high levels would be doing for my body.

 

[donnyguy59]

Hi Donnyguy,

What sort of things are you eating at the moment. Those are really high readings. I am surprised that you were happy to do lots of 'food scoffing and beer guzzling' when you were already so high.

Have you tried going low carb for any time? While I find that intermittent fasting or one meal a day can help it doesn't help if that one meal has too high carbs.

I would be concerned about the amount of carbs in beer for example- I think there are some low carb beers but I'm not a beer drinker so don't really know.

There is still a lot you can eat doing low carb and I really really recommend that you try it for a couple of weeks and see what effect it has on your levels.

If I had your levels I would be concerned about the possible damage that the high levels would be doing for my body.

 

[donnyguy59]

Just been to see Diabetic Nurse for results of recent HbA1C blood test. She gave me a reading of 68. I asked what the equivalent figure was for comparing with finger prick tests and she said 8.4. I know this is wrong. Research suggests she has just told me the old type of reading and the new type of reading. I want to know how to calculate these readings into mmol/L, which is what my meter reports. My meter today showed a reading of 20.2 and I have been over 15 for several weeks, this last week nearly reached 30mmol/L. So what is HbA1c figure of 68 as mmol/L? Does anyone know the correct conversion please. Shes going to add a second drug (sglt2) to take with Metformin next week.

 

[Bildad]

According to The calculator on this site it equates to 10.8. It would be unusual for your Hba1c to be wrong more likely your meter isn't working properly.
Are you sure your hands are clean and dry? Have you tested the meter with control solution?

 

[ianf0ster]

HbA1C is a 10 to 12 week average. Most people have a lower BG while they are asleep and peaks between 30 and 120 min after meals (depending upon what was eaten, how much of it and what it was eaten with (e.g. Fats and/or Alcohol slow the spike from Carbs).
So there is never a proper comparison: 7.0 is the average of 6.5 and 7.5 (which I would be OK with) - but it is also the average of 4.5 and 9.5 and 9.5 is too high for my liking!

 

[Winnie-the-Pooh]

Just been to see Diabetic Nurse for results of recent HbA1C blood test. She gave me a reading of 68. I asked what the equivalent figure was for comparing with finger prick tests and she said 8.4. I know this is wrong. Research suggests she has just told me the old type of reading and the new type of reading. I want to know how to calculate these readings into mmol/L, which is what my meter reports. My meter today showed a reading of 20.2 and I have been over 15 for several weeks, this last week nearly reached 30mmol/L. So what is HbA1c figure of 68 as mmol/L? Does anyone know the correct conversion please. Shes going to add a second drug (sglt2) to take with Metformin next week.

I suggest to get a GCM device to monitor your bg levels real-time if ur insurance covers it or you can afford .

I have a GCM. It is a tiny tiny device that I painlessly attach to myself ( leg , arm , whatever ). It gives me my blood sugar level every 5 min , constantly . I can see what increases my bg, how much and therefore I can tune my diet so my bg is within normal at all times . Also it sends me alarm if it goes too high or low so I take action .


I have Dexcom g6 brand but I know there are cheaper brands such as free style Libra that work well too . There must be other brands too . I got this one based on a colleague recommendation. I highly suggest it, given the fact that your bg is very high and you would like to improve your diet .

Also GCM helps to see if your medicine works and see how stress , poor sleep contributes to your high bg .

My device gives me predictions , customized reports and ability to share the reports with my medical team . I also can share my bg levels with my friends and family real-time so they can make sure I’m safe .

I think given that your high bg levels , you need to see someone more knowledgeable than a nurse or maybe even a general practitioner, depending on ur condition . Can u ask to see an endocrinologist ( I have no idea how NHS works) ?

Diabetes is a very serious illness and we ideally want a very good team of relevant specialists on our side . I was very unhappy with my GP after she failed to do the right test and take swift action that landed me in hospital .

I was very very sick. So I fired my GP and immediately got 2 endocrinologist( for a second opinion), a nephrologist, an optometrist, and a nutritionist. I wanted to make sure I won’t suffer from any long term damage and I get regularly tested for all potential complications .

Now I cannot be any better . My bg level before meal , after meal, during day and night is perfect . No high spikes and no symptoms. I feel healthy and happy and on the right dose of medication, my new diet is tuned to me specifically ( based on my GCM reports and reactions to certain foods), it works well and easy to follow ( well I miss certain things on my menu of course - being a foodie ).

Good doctors and my GCM device saved me in 10 days

 

[Brunneria]

Hi @donnyguy59

Here is a graph showing how to ‘translate’ the HbA1c units, and compare them to prick testing

You still haven’t mentioned what it is you are eating before you get these readings.
Have you continued with the low carb way of eating that you posted you had adopted following diagnosis?

when someone gets a surprisingly high reading, it is always best to wash hands and test again, in case there was any residue on the finger affecting the reading.
Other precautionary steps are to check the date and condition of your test strips (have they been left in the sun, or expired).

can you check your food diary (if you have one) to see what the same foods, in the same portions, were doing to a while back?

And when you were given your T2 diagnosis, were any tests run to check for other forms of diabetes, such as T1 and MODY?
I see from your profile that you are on Metformin and have lost some weight since diagnosis, but unfortunately (and contrary to the mistaken impression in the media and amongst some health professionals), being over weight and ‘middle aged’ does NOT automatically mean that someone gets T2. Other types of D exist, and if we look like typical T2s we can get pigeon holed v easily into the wrong category. So I suggest that you ask for GAD and c-peptide tests, to ensure that your nurse’s new treatment suggestion is the most appropriate option for you.