I have no clue what to do...please help

[RooMumOf3]

So my partner has got type 2 diabetes and has done for nearly 3 years. He's had his hb1ac check done and since October it's gone from 55 to 103. During this time he's doubled his metformin to 1g twice a day modified release so we were expecting it to drop down further.
He's been given a blood monitor to do at home but having a call with the nurse on Monday to discuss the results. His reading yesterday morning before food was 31.8, it dropped during the day to 28 then again to 21 but should we be contacting a gp quicker than Monday? Today they were all between 25 and 19. We have nothing to compare these results too so unsure if he should be making urgent calls or just waiting to speak on Monday.
He feels fine in himself but have no clue what to do over the weekend...

 

[DCUKMod]

So my partner has got type 2 diabetes and has done for nearly 3 years. He's had his hb1ac check done and since October it's gone from 55 to 103. During this time he's doubled his metformin to 1g twice a day modified release so we were expecting it to drop down further.
He's been given a blood monitor to do at home but having a call with the nurse on Monday to discuss the results. His reading yesterday morning before food was 31.8, it dropped during the day to 28 then again to 21 but should we be contacting a gp quicker than Monday? Today they were all between 25 and 19. We have nothing to compare these results too so unsure if he should be making urgent calls or just waiting to speak on Monday.
He feels fine in himself but have no clue what to do over the weekend...

Roo, and those numbers are concerning.

Obviously I know nothing of your husband, or his condition, but numbers like that won't be doing any good. If you have a way of testing his bloods for ketones, please do.

Bearing in mind you have the weekend ahead of you, I would be inclined to suggest you call NHS online on 111 for advice.

 

[JoKalsbeek]

So my partner has got type 2 diabetes and has done for nearly 3 years. He's had his hb1ac check done and since October it's gone from 55 to 103. During this time he's doubled his metformin to 1g twice a day modified release so we were expecting it to drop down further.
He's been given a blood monitor to do at home but having a call with the nurse on Monday to discuss the results. His reading yesterday morning before food was 31.8, it dropped during the day to 28 then again to 21 but should we be contacting a gp quicker than Monday? Today they were all between 25 and 19. We have nothing to compare these results too so unsure if he should be making urgent calls or just waiting to speak on Monday.
He feels fine in himself but have no clue what to do over the weekend...

That's high... If you can manage it this weekend, cut carbs rather drastically. (Practically all carbs turn to glucose once ingested.) So no cereal of any kind, no bread or anything else flour-based, spuds, pasta, rice, fruit, corn, none of any of that... Stick with eggs and bacon, above-ground, non-starchy veggies (like broccoli, cauliflower, leafy greens), poultry, meat, fish, nuts, olives, cheeses... Those numbers really do need to come down and if there's no help around just yet, (like, indeed, 111), this is basically the only way to get them lower. Besides maybe going for a long walk as well. Keep testing, and maybe have a read here: https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html

Good luck!!!!
Jo

 

[EllieM]

The concern with such a sudden change in hba1c is that he may be T1/LADA rather than T2. This can develop very slowly and modifications in diet can control it for years until insulin production goes to low for his body to cope. When this happens, diabetic ketoacidosis is a risk, which is why @DCUKMod asked about ketones. Once DKA hits, it needs immediate hospital treatment.

So I second the suggestion that you ring 111 for advice. If you do have access to ketone testing (some chemists sell urine testing strips rather than the more accurate blood testing machines) you could reassure yourselves by testing to see whether he's running high levels.

 

[jjraak]

So my partner has got type 2 diabetes and has done for nearly 3 years. He's had his hb1ac check done and since October it's gone from 55 to 103. During this time he's doubled his metformin to 1g twice a day modified release so we were expecting it to drop down further.
He's been given a blood monitor to do at home but having a call with the nurse on Monday to discuss the results. His reading yesterday morning before food was 31.8, it dropped during the day to 28 then again to 21 but should we be contacting a gp quicker than Monday? Today they were all between 25 and 19. We have nothing to compare these results too so unsure if he should be making urgent calls or just waiting to speak on Monday.
He feels fine in himself but have no clue what to do over the weekend...

I'd certainly second the advice above and MAKE that call.

Not sure what regime your partner had used, but presume they felt happy enough until October using it. ?

Had something changed then?
Job, other illness or maybe some stress or bereavement?

All those thing COULD raise their level, but that is I think a pretty drastic rise, and numbers now are definitely too high... So he does need to get it checked as stated above.

I do despair that we get left with too little information sometimes, and rather just left to middle through.

A worry for you both, so best wishes the cause is found asap... But kudos to you for reaching out so quickly for other help.

 

[Daphne917]

So my partner has got type 2 diabetes and has done for nearly 3 years. He's had his hb1ac check done and since October it's gone from 55 to 103. During this time he's doubled his metformin to 1g twice a day modified release so we were expecting it to drop down further.
He's been given a blood monitor to do at home but having a call with the nurse on Monday to discuss the results. His reading yesterday morning before food was 31.8, it dropped during the day to 28 then again to 21 but should we be contacting a gp quicker than Monday? Today they were all between 25 and 19. We have nothing to compare these results too so unsure if he should be making urgent calls or just waiting to speak on Monday.
He feels fine in himself but have no clue what to do over the weekend...

As others have suggested ring 111 for advice.

 

[Oldvatr]

That's high... If you can manage it this weekend, cut carbs rather drastically. (Practically all carbs turn to glucose once ingested.) So no cereal of any kind, no bread or anything else flour-based, spuds, pasta, rice, fruit, corn, none of any of that... Stick with eggs and bacon, above-ground, non-starchy veggies (like broccoli, cauliflower, leafy greens), poultry, meat, fish, nuts, olives, cheeses... Those numbers really do need to come down and if there's no help around just yet, (like, indeed, 111), this is basically the only way to get them lower. Besides maybe going for a long walk as well. Keep testing, and maybe have a read here: https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html

Good luck!!!!
Jo

Four years ago I was in the same position. I turned it around by doing what is described in the referenced post above, and I have been in control and getting good HbA1c results since. I too was getting meter readings off the scale (i,e, > 32) so now is the time to bite the bullet and get stuck in, If after dropping the carbohydrate intake the meter still stays high then yes use NHS !!! and seek advice But be aware that his liver will try to maintain bgl levels high and will act by taking sugar that is already stored in the body to bolster the levels for a while until things settle down, so the drop in bgl will not be immediate. I took a couple of weeks of low carb before i started to see real benefit.

The Metformin is useful for diabetics, but it is not very effective at reducing blood sugar levels. It has limited effect and will only drop the bgl by 1 or 2 mmol/l on the meter. Dropping carbs will give better results and is actually relatively simple to achieve. The low carb subthread here in the forum may help with advice and ideas on how to do it.

 

[Honeyend]

Hi, although his BS is high depending on what he has eaten that could be the reason. The best way to explain this is to have a look at this.
https://phcuk.org/wp-content/uploads/2019/03/Common-Foods-29.03.2019.png
If he is not eating hardly any carbs, he is obviously not processing the 'sugar ' at all. I would ring 111 for advice, they may send him to see a GP at a drop in centre.
It looks like your first post and if you are not already aware if you have too much sugar in your blood you can get DKA
https://www.nhs.uk/conditions/diabetic-ketoacidosis/
Not everyone gets it, even with a raised BS, but its something to be aware of.

 

[RooMumOf3]

Thanks all. He has got his levels to between 19 and 20 all day today so we are not so concerned as yesterday. We are going to see what tomorrow brings but he has drunk more water today, cut most carbs out, he was pleased about the bacon this morn, I asked in the pharmacy about ketone strips and they didn't have any but I'm gonna try another tomorrow, at least then when he speaks to them on Monday he has something to add in if it's really bad, or at least if it comes back bad I have more ammo to call 111, he doesn't want to bother them. I have been reading loads of bits of info and found so much confusing but I guess until we know a little more we are just bumbling through, thankfully it's only another day til we get some answers. I'll pop an update on when we know. Thanks again x

 

[HSSS]

Glad they are a little better but they are are still far too high and something to keep working on. Maybe a continued drastic reduction in carbs will do the job so keep going there, it can take a while for them to come down to decent levels but you should see continued improvements as a trend.

So the big question is why the rise?

Things to consider
1. Any other medications added in. Some like statins or steroids can raise numbers quite a lot
2. Any change in diet? Eating more carbs? Drinking more beer or fruit juice? Snacks away from home sneaking in?
3. Other illnesses?
4. New stresses?
5. Could it be in fact slow onset type 1 - LADA and never was type 2 at all. surprisingly high numbers of such people are misdiagnosed at first. This needs c-peptide and Gad antibodies testing for.

 

[RooMumOf3]

Glad they are a little better but they are are still far too high and something to keep working on. Maybe a continued drastic reduction in carbs will do the job so keep going there, it can take a while for them to come down to decent levels but you should see continued improvements as a trend.

So the big question is why the rise?

Things to consider
1. Any other medications added in. Some like statins or steroids can raise numbers quite a lot
2. Any change in diet? Eating more carbs? Drinking more beer or fruit juice? Snacks away from home sneaking in?
3. Other illnesses?
4. New stresses?
5. Could it be in fact slow onset type 1 - LADA and never was type 2 at all. surprisingly high numbers of such people are misdiagnosed at first. This needs c-peptide and Gad antibodies testing for.

No new meds, no added stress that I'm aware of, in fact we were saying how relaxed stuff was just ticking over, no new illness we are aware of yet, he's on lisinopril and atorvastatin which have meant his blood pressure is Perfect, and they've not mentioned a change in his cholesterol, they only put him on it as a precaution cos of family history. He is over weight and we are following slimming world at home but his weight losses have slowed over Xmas, but we barely drunk over Xmas and new year as I had health issues which meant I couldn't drink so he stayed off as well in support, I'm all good so it wasn't extra stress just needed to watch my diet for a few weeks. It's really odd with the rise, but both his parents died early so we don't really know their medical history, and as he's now older than they both were when they died we don't know if they would've got diabetes if they lived longer or even if they had it undiagnosed. His sister has medical issues but not diabetes, but his uncle is t2 and on a concoction of meds, he didn't cope well on standard release metformin either so went to glucophage also but his was a bit weird and he's now on something else, we only just found this out so still finding out what to see if it's a family connection to link too.

 

[Resurgam]

The usual slimming world diet is high in carbohydrate - it is not diabetes friendly at all.
Can you give us an outline of what your partner has been eating?

 

[EllieM]

Still concerned that DKA is a real risk, those levels are still very high, ring 111.

 

[KK123]

Still concerned that DKA is a real risk, those levels are still very high, ring 111.

I agree. It's all very well advising someone to go low carb and ask what they are eating but the priority is to get proper medical advice first and foremost. I say this because my introduction to diabetes was the same 'Eat fewer carbs, look at lifestyle' and a few days later my levels were still sky high, I had ketones and off to hospital pronto on the verge of DKA. Type 1.

 

[HSSS]

I agree. It's all very well advising someone to go low carb and ask what they are eating but the priority is to get proper medical advice first and foremost. I say this because my introduction to diabetes was the same 'Eat fewer carbs, look at lifestyle' and a few days later my levels were still sky high, I had ketones and off to hospital pronto on the verge of DKA. Type 1.

Agreed. I never meant my comments as an “instead” rather more an “as well” - should have made that clearer. Although I suspect diet could still be a major factor and cutting the carbs can only help no matter what other help is being sought simultaneously.

 

[HSSS]

No new meds, no added stress that I'm aware of, in fact we were saying how relaxed stuff was just ticking over, no new illness we are aware of yet, he's on lisinopril and atorvastatin which have meant his blood pressure is Perfect, and they've not mentioned a change in his cholesterol, they only put him on it as a precaution cos of family history. He is over weight and we are following slimming world at home but his weight losses have slowed over Xmas, but we barely drunk over Xmas and new year as I had health issues which meant I couldn't drink so he stayed off as well in support, I'm all good so it wasn't extra stress just needed to watch my diet for a few weeks. It's really odd with the rise, but both his parents died early so we don't really know their medical history, and as he's now older than they both were when they died we don't know if they would've got diabetes if they lived longer or even if they had it undiagnosed. His sister has medical issues but not diabetes, but his uncle is t2 and on a concoction of meds, he didn't cope well on standard release metformin either so went to glucophage also but his was a bit weird and he's now on something else, we only just found this out so still finding out what to see if it's a family connection to link too.

How are the levels today? Have you sought any medical advice? Tested for ketones?

Statins have been known to make people diabetic. When did he start them? There’s a lot of research now that says they aren’t even particularly beneficial. It’s crazy in my view to be on a medication if there’s nothing wrong with your levels (which he doesn’t know there is anyway) on a just in case basis. Especially if they could be making his diabetes worse!

when did he start slimming world? As said above it can be very carb heavy and quite unsuitable.

It’s not just sugar that needs eliminating. All bread, rice, pasta, grains including flour products, potatoes And most fruits with the exception of berries will all likely make levels rise quite high in most diabetics. And the colour of said product makes little difference to how many carbs it has. The rise might be marginally slower in the brown versions but it still goes up and at this point that is seriously unwanted.

 

[Estragon]

I went from 89 HBA1C down to 64 HBA1C in the space between late September 19 till 2 December 19. I did this by eradicating Carbs, my Doc doubling my Met from 1mg to 2mg per day and reading extensively on this Myth Busting Forum. So, notwithstanding any underlying medical issues, your hubbie can and will do it, especially as you’ve proved to be a concerned and caring partner! You’ve done very well indeed. Keep coming here for facts and support.

If he’d like to, maybe he could come and chat here too?

 

[Seacrow]

Thanks all. He has got his levels to between 19 and 20 all day today so we are not so concerned as yesterday. We are going to see what tomorrow brings but he has drunk more water today, cut most carbs out, he was pleased about the bacon this morn, I asked in the pharmacy about ketone strips and they didn't have any but I'm gonna try another tomorrow, at least then when he speaks to them on Monday he has something to add in if it's really bad, or at least if it comes back bad I have more ammo to call 111, he doesn't want to bother them. I have been reading loads of bits of info and found so much confusing but I guess until we know a little more we are just bumbling through, thankfully it's only another day til we get some answers. I'll pop an update on when we know. Thanks again x

If you want more ammo, tell him this - at bg levels over 30 he is doing permanent and irreversible damage to his eyes and kidneys. I think it is probable that if he had gone to the GP the doctor would have phoned for an ambulance for him there and then. (The GP has done so for me in the past, that was bg of 30 and ketones of 2.)

If you have managed to test ketones before you get to talk with a nurse or doctor, you might need to go straight to A&E. I have an agreement with my GP, if my ketones ever test at 4 or higher, I go straight to emergency admittance, no arguing allowed. I'm not saying this is the level you should go in at, but it's a guide.

I would be really quite worried. Sorry, this is probably not what you want to hear. It is very good that he's managed to get his bg levels down a bit, but they're still way higher than they should be.

 

[Estragon]

I would be really quite worried. Sorry, this is probably not what you want to hear. It is very good that he's managed to get his bg levels down a bit, but they're still way higher than they should be.

Yes, I agree.

 

[KK123]

Agreed. I never meant my comments as an “instead” rather more an “as well” - should have made that clearer. Although I suspect diet could still be a major factor and cutting the carbs can only help no matter what other help is being sought simultaneously.

Hi HSSS, I do get what you are saying but at the start of the diabetes 'journey', it can take weeks to establish what type you have and if you change your diet drastically whilst still undergoing assessment then this in itself can mask any true diagnosis. If for example, a person immediately cuts out carbs in the days following diagnosis, the first blood test they have might come up with a low hb1ac. Mine would have because I too panicked and went straight for low carb. This meant it took weeks of extra confusion before they eventually did a C Peptide & GAD test which showed type 1. They kept saying 'Well this person has normal glucose levels' and yes I did, but ONLY because I wasn't eating any carbs. After around 2 months the proper tests were done but in the meantime I was on insulin, off insulin, back on it, hypo'ing, off insulin, back on it....well, you get the drift! I personally think that there could be real problems if a person who later turns out to be type 1 is 'advised' to go low carb before diagnosis although I agree, AFTER diagnosis then at least an informed choice can be made.