Not Happy with My Blood Sugar Control

[Paul Hearn]

I have been diagnosed with type 2 Diabetes for around ten years. Initially I was controlled by diet, Metformin and Glicklacide. My Hba1c has been gradually rising and is now 8.7. At first to keep this rise in check I was given Byetta then replaced by Victoza (1.2 once a day) whilst on Lantus(50 twice a day). I am also taking 1000mg Metformin MR twice a day. Up until last week my waking sugar reading was around 9 but my evening readings could be as high as 22. I eat my main meal in the evening and I do have a sweet tooth that I struggle to keep in check. At my Hospital appointment last week the doctor took me off Victoza and put me on Humalog starting at 10 clicks twice a day. I have since increased this to 20 clicks after food up to 3 times day. My waking bloods sugar have increased to around 13. I now feel as if I am going backwards and getting very worried for the future.
My questions are:
1. Would I benefit from using Victoza and Humalog(given its not recommended & Victoza is not fully licensed)
2.Is it OK to keep increasing Humalog based on blood readings aiming for 5-7 readings with meal spikes or am I dreaming!Also what would be considered an upper limit of this drug?
3. I'm thinking of modifying treatment to 1 x Metformin twice a day : 1.8 Victoza once a day : 50 Lantus twice a day : Humalog 30 at meal times variable based on meal.

I can't go to my doctor as they will not prescribe Victoza and my next hospital appointment is in 6 months time.

 

[Grazer]

I'm afraid I know little about these drugs, but what sort of diet are you on? Have you tried modifying that rather than the drugs?

 

[Paul Hearn]

Thanks for your reply. I think I am dillusional in believing the drugs alone will solve my problem.....even after 10years!! My diet during the day is pretty good. But after work and at home it all goes out the window. I do have a sweet tooth which I am fighting all the time. Must try and do more exercise!!!

 

[viviennem]

Paul Hearn posted:

My diet during the day is pretty good.

That still doesn't tell us what you eat, Paul. For instance, if I ate what the NHS and DIabetes UK consider to be a "pretty good" diet, my blood glucose would be high and getting higher - I can't take that much carbohydrate.

I know low-carb doesn't suit everyone, but it might be worth having a really good look at what you eat, working out how much carb you consume in a day, and seeing if you can make a few little adjustments to lower it. It could help. Also increase your exercise a bit, if you are able to. That should help as well.

Viv 8)

 

[Grazer]

That still doesn't tell us what you eat, Paul. For instance, if I ate what the NHS and DIabetes UK consider to be a "pretty good" diet, my blood glucose would be high and getting higher - I can't take that much carbohydrate.

I agree Paul! 'Fess up!

 

[Paul Hearn]

I do know what I should and shouldn't eat I was diagnosed over ten years ago. Without going into a full food diary sufice to say a small bowl of cereal for breakfast and a filled roll if I have lunch. I am aware that carbs are bad and sugar is a no no, but I am not prepared to survive on rabbit food and water. I like chocolate and pastry & potatoes and do eat in moderation. Iam not going to let this condition rule me!

 

[Grazer]

Arguably it is ruling you if you're not happy (as you say) with your BG. You don't need to eat rabbit food - I don't. I have burgen bread sandwiches at lunch rather than a roll, new potatoes rather than old, pastry made from carbalose flour from the low carb megastore rather than normal White flour, a few squares of Thornton's diabetic chocolate and so on.

 

[Unbeliever]

My HBA1C was rising like yours and I couldn't understand why as I had a "good " diet too.

When I decided tto take charge myself I was amazed o find that my tolerance of carbs was almost nil.

I also found that although my levels were , in general , reasonable. I was suffering spikes actually when eating LESS than usual. Januvia solved that paricular problem which was dure to "liver dumping" but
increased exercise - just walking- and cutting right down on the starchy stuff has lowered my HBA1C considerably and best of all - if I keep the carbs down I find that he occasional sweet treat makes very little difference to my readings.

I never had a particularly sweet tooth in general , but there were certain things I could never resist and no find I don't need to cut out completely. I sometimes wonder if these cravings for sweet things are caused by diabetes as I am sure my blood sugar used o drop at a erain ime of day and my body demanded a sugar fix to keep up the high levels, Before diagnosis I mean,

I reacted just as you did when I first came on here and was asked about my diet. I am not an extreme low carber by any means - don't even count thae carbs mosy of the ime but it was a revelation o me how sensitive I was to bread . pasta and potatoes. Now I can eat a little of them without any ill effects.

Worth a try perhaps? Good luck with whatever you decide.

 

[Paul Hearn]

Thanks for your input. Not sure how you count carbs, I guess the same way you count calories.

Having a weight problem hense diabetes has meant my watching what I eat for as long as I can remember.

I still get very annoyed when told what I can and can't eat as it seems the list of what I can eat from is getting smaller and most that is left very unappetising.

Thanks again.

 

[simply_h]

Hi there Paul,

Hope you are well.

First thing I am no expert, my ONLY experiences are from myself and learning from this forum.

After reading you posts –you seem to have started really well since diagnoses, but you are having issues now.

May I ask how old you are?
What is you BMI and weight?
How much exercise to you do?
Is there ANY medical reason why you cant to exercise?

As I do personally believe that exercise if the key for us diabetics, both cardio and building muscle.

If you couple exercise with a low / Low-ish carb diet, I feel that you will see a lot of benefits very quickly.

Also it would be really good for you to post what you actually in a day for a few day typically, as there is some really good people who can give you some really good advise.

Good luck,

Cheers
Simply_h.

 

[borofergie]

I still get very annoyed when told what I can and can't eat as it seems the list of what I can eat from is getting smaller and most that is left very unappetising.

Then eat what you want and deal with the consequences later. You might be lucky and there might not be any.

I'm not aware of any T2 diabetics that get to eat whatever they fancy (while being well controlled), no matter how much "antidote" they take. There is a big difference between "low-carbing" and carefully reducing the amount of carbs you eat. Are you sure you really can't get by without cereal, sandwiches and sweet stuff?

Sorry to sound harsh mate, but there isn't a magic bullet solution for any of us, and we all have to make some sort of sacrafice if we want to beat this diabetes thing.

 

[WhitbyJet]

Paul - dont despair. There was a time when I felt just like you do now, I used to think I will never healthy again, as for being able to enjoy my food? Forget it, like you said, all the foods I enjoyed eating were struck off the menu, bit by bit, depressing wasnt the word.
I started off with good old NHS dietary advice, my lovely dietitian took great care in devising a precise menu, 3 oz of this and 2 oz of that - it didnt work, I didnt lose weight nor did I manage to lower my blood sugar, despite stubbornly sticking to the diet and swalling a fistful of medication three times a day.

Eventually I started low carbing, I felt I had nothing to lose, food was not going to be pleasure anymore anyway. How wrong I was. I learnt to adapt recipes to make them low carb, yes they do taste a little different, but not terribly so.
To give you an example, on Friday I made a big pot of stew and dumplings, I used low carb vegetables with the meat, but no flour to thicken the gravy. At the end of cooking time I pureed some of the veg (use stick blender for that), added 1 teaspoon of guar gum (read the labels on supermarket food, its a very popular ingredient, natural too) and this thickened the sauce nicely.
The dumplings I made per usual recipe, I replaced the flour with almond flour and a little of freshly ground golden linseed, added a tablespoon of finely chopped parsley, - perfect.
Got the thumbs up from the family as well as daughters 2 schoolfriends who were staying for dinner.
For dessert they had a slice of low carb chocolate cake and low carb vanilla ice cream.

Breakfasts - if you are a ceral person, check out the thread Liz's Granola, or if a fry up is more of your thing, you could have eggs, bacon, sausage (read the label, high meat content have few carbs), mushroom and tomato, leave out the beans, I bake my own low carb bread but many members of this forum will tell you that they are fine with a couple of slices of Burgen bread so you could give this a try.

So you see, its possible to eat delicous food, its just a matter of being flexible and adapting, on top of it you will have the satisfaction of knowing that you are doing something very positive for your health,

Now I only told you here about low carbing, but it might not be your thing at all, so you might want to consider low GI instead.
I am sending you two links, Rick Gallop has written some very good books on this subject you can find recipe samples and more information online.

http://www.glycemicindex.com/

http://www.google.co.uk/#sclient=psy-ab ... 60&bih=616

Please dont feel resentful, it causes stress and that alone is enough to raise blood sugar. You can learn to be in charge of your diabetes and still enjoy your food.
If you feel that I can help you with anything, dont be afraid to say so.

All the best

 

[Unbeliever]

I think you are quite right about the resentment Whitbyjet. It is hardly surprising that people feel resenful if they are told what to do and harangued when it doesn't work while worrying about their help.

The only way to stop feeling this way is to take charge yourself and recognise that you are doing it for YOU.It is hard to take a positive attitude when all you hear is that you can't do this and must give up that.
Becoming interested in a different way of eaing rather than concentrating on what you can't eat is , helpful to many people. I am sure having others to cook for and adapting recipes helps you too.

For those who don't have to do that just finding out what different foods do to you and what you CAN eat may help.

I don't eat red meat and have food allergies which have put me in hospital and I HATE salad so I cope in different ways but- whatever works for you.!

 

[smeatons]

I don't believe you have to eat rabbit food to keep things under control.
I don't confess to doing a low-carb diet, but I do watch the amount of carbs I eat and tend to "trade-off" carbs against each other.

For example for breakfast I have one of the follow cereals:

[*]ASDA Indulgent Treats (various types such as Apple Crumble & Custard Crunch) 45g = 20.7g
[*]Jordans Country Crisp Chocolate 40g = 26.28g of carbs
[*]Fruit 'n Fibre 40g = 27.6g of carbs

For lunch I have a small ham salad brown roll sandwich
Currently I am tending to go low at around 4:30pm-5pm, so have either a packet of crisps (french fries) or two chunks of dairy milk chocolate

For evening meal I have something like:

[*] Jacket potato, selection of cold meats and as much salad as I want. Sometimes include a low fat humous with it.
[*] Salmon, new potatos and green vegatables
[*] Gammon, oven chips and reduce salt/sugar baked beans

For pudding I usually have yoghurt, the three types I've found work for me are:

[*]Irish diet yoghurt
[*]Activia fat-free
[*]Weight-watchers

9 to 11.8g of carbs depending on flavour.
Also some Fromage Frais are <10 grams of carbs

Drinks throughout the day will either be water, sparkling mineral water or diet drinks such as Dr Pepper Zero, Diet Cherry Coke, Diet Coke (all of which are zero carb) or if numbers are ok sometimes I'll do things like Fanta Zero which has a very small amount of carbs in it or at night a highlights hot chocolate drink

If I need to snack outside of that I have a drink and wait 20mins or so to see if I really am hungry and if so I move onto my cheat foods: the highlights hot chocolate drink (kind of like food), KP salted peanuts or cheese on a couple of jacobs high-fibre crackers - don't recommend any of these, but sometimes needs must and these are the lowest carb snacks I've found I like.

Great thing is (apart from weighing my breakfast) I don't feel like I'm on a diet.

I'm not saying this is right for you, but just some ideas of what works for me.
Following this routine I've pretty much got my blood sugars under control and I've been losing on average about 1kg per week!

regards,
David

 

[Dougie22]

I too come from your sort of lifestyle and work and I don't really eat rabbit food or anything from a health food store....but I didn't want my doctor to med me up to the hilt so I started to think about it a bit more than I had. I now , most of the time, eat what any reasonable person would call a healthy mixed diet with an emphasis on reduced carbs (not low carbing) and things are going quite well.

I'd really recommend taking one full day and writing down absolutely everything you eat along with the calories, carb content and salt. This is quite a major effort. You'll need to read every label and have a calculator. You may also need a calorie count book (which will give you the carbs as well) or an on-line site.

It's really a lot of work but I think you might be amazed at what you'll find out, especially if you pick a "normal" day for you rather than a "good" one.

If you then combine what you've learned with some self BG testing, you'll be well on the way to gaining control.

 

[Paul Hearn]

Thanks to everyone who took the trouble to express their thoughts, views, opinions and experiences. I was amazed at the response and the trouble people went to with their help. I have taken on board all you've suggested and realise I must be more pro-active than I have been, rather than carry on as before diagnosis expecting the drugs to do all the work for me.
Many thanks
Paul

 

[WhitbyJet]

Paul - good luck with it all, ask as many questions as you like.

From all the answers you can see that altough we all have diabetes we each have found our own individual way of dealing with the beast. Go for it, dont let it beat you

 

[Stevenjobs]

Hi Paul, Try to consult a doctor.They will help you to plan your diet program.

Wish you good luck and be happy always...............

 

[Mandylou]

I was the same with my diet when I was first diagnosed, with the nhs advice of " eat lots of starchy carbs" well my readings were creeping up and up and I was injecting 100 units of novirapid and 50 units of levimer a day !! My readings were 16.0 upon waking and sometimes up to 21 after my evening meal! . So I took matters in to my own hands after looking for support
here and tried going very low carb. After two weeks my sugar levels haven't gone over 8.0 and my waking levels are between 5.0 and 7.5. Also lost a stone in weight! So win win xxxx

 

[Mandylou]

Should have said, I'm now on 26 units a day novorapid and 30 units levemer ! Result!