Type 2 Haven't got a clue!

[jpatricia]

Good morning all,
I would like some guidance please.

I am 82 years, live alone. My children live, variously in, Chile, USA, and New Zealand. I have very good friends and a cousin with family I'm very close too, nearby.
My husband died April 2017 after three years of emotionally and physically exhausting illness. By which time I was taking anti depressants. He hated being ill and it showed in very unpleasant ways.

Six months after his death I was diagnosed with a heart problem. Stent fitted December 2017. Strong family history of heart problems

Diagnosed with type 2 in May 2018. A reading of 7.0. Had the usual check ups. Attended a Desmond course. Agreed with diabetic nurse to try and reduce weight etc before having medication. BMI 29. 1.60 height.
Gave up alcohol, reduced carbs , tried a little more exercise, (cannot walk much due to mild spinal stenosis, so swam).

September 2018. Saw different nurse who recommended metformin, 500mg as not much progress. Really struggled with this for a month or so then settled. Initially lost 4kg. Then crept back up. Interim, retinopathy tested okay.

Tried low carb diet which left me angry, hungry and exhausted.
March 2019 bloods showed reading of 6.4 and improvement all round (except weight). Continued life.

September 2019. Nurse tested for loss of sensation in feet, no problem.
Since then I haven't had any tests or feedback.Apart from retinopathy. My weight creeps upward, now with serious lack of any meaningful exercise due to ,we all know what!

I'm getting really concerned about where I'm at. I sense things are not as they should be.

Overwhelming exhaustion and from around 4.00pm, hungry all the time. As soon as I cut back on food, carbs in particular, I become nauseous, dizzy and lightheaded.

The surgery is telephone consultation only, (completely understandable). I don't know what to do.

Advice welcomed

Thank you Patricia Harris

 

[xfieldok]

You have been through a horrible time and I am sorry for your loss.

You say you have tried low carb but it left you hungry? If done properly you should not be hungry.

Carbs are key to controlling T2. It is a metabolic disorder which means we cannot process carbs.

Would you be prepared to give it another go with our help?

 

[JoKalsbeek]

Good morning all,
I would like some guidance please.

I am 82 years, live alone. My children live, variously in, Chile, USA, and New Zealand. I have very good friends and a cousin with family I'm very close too, nearby.
My husband died April 2017 after three years of emotionally and physically exhausting illness. By which time I was taking anti depressants. He hated being ill and it showed in very unpleasant ways.

Six months after his death I was diagnosed with a heart problem. Stent fitted December 2017. Strong family history of heart problems

Diagnosed with type 2 in May 2018. A reading of 7.0. Had the usual check ups. Attended a Desmond course. Agreed with diabetic nurse to try and reduce weight etc before having medication. BMI 29. 1.60 height.
Gave up alcohol, reduced carbs , tried a little more exercise, (cannot walk much due to mild spinal stenosis, so swam).

September 2018. Saw different nurse who recommended metformin, 500mg as not much progress. Really struggled with this for a month or so then settled. Initially lost 4kg. Then crept back up. Interim, retinopathy tested okay.

Tried low carb diet which left me angry, hungry and exhausted.
March 2019 bloods showed reading of 6.4 and improvement all round (except weight). Continued life.

September 2019. Nurse tested for loss of sensation in feet, no problem.
Since then I haven't had any tests or feedback.Apart from retinopathy. My weight creeps upward, now with serious lack of any meaningful exercise due to ,we all know what!

I'm getting really concerned about where I'm at. I sense things are not as they should be.

Overwhelming exhaustion and from around 4.00pm, hungry all the time. As soon as I cut back on food, carbs in particular, I become nauseous, dizzy and lightheaded.

The surgery is telephone consultation only, (completely understandable). I don't know what to do.

Advice welcomed

Thank you Patricia Harris

Hey Patricia,

I'm so sorry for your troubles and loss. It does tend to stack up sometimes eh... Like having one thing at a time to deal with isn't quite enough.

So here's what we can help with: You cut carbs, but I have a distinct feeling you didn't up the fats as you did so... (Correct me if I'm wrong!) That makes one not only hungry, but deficient in all sorts of vitamins and minerals. That would explain why you were hungry all the time and feeling off. I'm guessing you had a lean breakfast rather an eggs, bacon, a tomato, cheese, and/or high meat content sausages for instance? Because I can guarantee you, with a meal like that, you wouldn't've been hungry for quite a few hours after. Lunch, dinner.... Fats and protein are your friends there. Don't leave the table hungry. Otherwise it's not going to work in the long run, which you've already noticed. Also, dizzy and lightheaded... If you cut carbs you often also miss a lot of salt from your diet. (As it is in bread and such). My blood pressure went from normal to low once I changed my diet, and I needed to up my salt intake some. Considering your heart issues you might be on blood pressure medication, that could clash with eating less salts and drop you too low, (medication might need adjusting) and if you are on statins, those tend to up blood glucose... With your history you might need them though, but they might be a reason, if you are on them that is, for slightly elevated numbers too. So you have a bit of a puzzle before you, but not anything that can't be solved.

If you can tell us what you used to eat when low carbing, and what you're eating and drinking now, we might be able to tweak your diet with you. The hive mind has a lot of suggestions and experience.

Oh, and if you're interested, have a read here: https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html Might help a little.

Good luck!
Jo

 

[NicoleC1971]

Dear Patricia, I am sorry you are anxious about your health and seem to be dealing with that alone. Your surgery can still ask some basic questions to rule out anything other than diabetic issues. Could you get your blood pressure and blood sugar checked at a local chemist as this may give a doctor some more useful info?
The very best thing you can do is focus on eating well by cutting out biscuits, cakes and sweet fruits which would raise your blood sugar. Often if you jump straight into low carb it will give you the symptoms you describe so I'd suggest taking a more gradual approach - more eggs, fish, chicken, rd meat, suasages plus green veg with less cereal, bread, rice and pasta but not putting too much presure on yourself at this difficult time.
Exercise at home indoors can just be walking up and down stairs or round the garden if you have one. If you have spinal stenosis you may even feel more comfortable standing up in any case?
The risk of this lockdown is that elderly but generally healthy folk like yourself do not feel they can bother their GP and might suffer with worry or other illness as a result so I hope you will talk to your GP orr pharmacisst to allay the worry. ANd you certainly won't be harming yourself by trying to eat a few less carbs.

 

[jpatricia]

Thank you to the lovely people that replied to my miserably post. After reading I realised how victim like it sounded.
So, before i got carried away it seemed a sensible first step to see medically where I was at.
Now I have had bloods taken with the result of a sugar measure of 7.0 (this was non fasting late am), at least there is a current measurement. I do have a telephone consultation set up with the diabetic nurse at the surgery next week to try and see what she suggests. I have never been offered kits for measuring blood sugar and prefer not to if possible.
So, you may ask, now....... what!
One of my major problems is a very carb heavy diet. Having just read fairly extensively various articles it seems everything is carbs! Having tried to reduce intake via ' my fitness pal's, I find trying to keep to 100g carbs per day extremely hard, partly because I have extreme acid reflux due to hiatus hernia using pantoprozole as an inhibitor. When I reduce the carbs I become nauseous, dizzy, hangry and very weak. Just to round things off exercise is very limited due to spinal stenosis. Usually I manage this with swimming, of course currently that isn't available.
Once more this seem 'poor little me', however truth is I haven't taken diabetes seriously enough and so I'm flapping around in a panic.
Thank you once again for your collective inputs, I intend to keep working on this. Patricia

 

[jpatricia]

Dear Patricia, I am sorry you are anxious about your health and seem to be dealing with that alone. Your surgery can still ask some basic questions to rule out anything other than diabetic issues. Could you get your blood pressure and blood sugar checked at a local chemist as this may give a doctor some more useful info?
The very best thing you can do is focus on eating well by cutting out biscuits, cakes and sweet fruits which would raise your blood sugar. Often if you jump straight into low carb it will give you the symptoms you describe so I'd suggest taking a more gradual approach - more eggs, fish, chicken, rd meat, suasages plus green veg with less cereal, bread, rice and pasta but not putting too much presure on yourself at this difficult time.
Exercise at home indoors can just be walking up and down stairs or round the garden if you have one. If you have spinal stenosis you may even feel more comfortable standing up in any case?
The risk of this lockdown is that elderly but generally healthy folk like yourself do not feel they can bother their GP and might suffer with worry or other illness as a result so I hope you will talk to your GP orr pharmacisst to allay the worry. ANd you certainly won't be harming yourself by trying to eat a few less carbs.

Thank you Nicole, I've written a more extensive reply below.

 

[jpatricia]

Hey Patricia,

I'm so sorry for your troubles and loss. It does tend to stack up sometimes eh... Like having one thing at a time to deal with isn't quite enough.

So here's what we can help with: You cut carbs, but I have a distinct feeling you didn't up the fats as you did so... (Correct me if I'm wrong!) That makes one not only hungry, but deficient in all sorts of vitamins and minerals. That would explain why you were hungry all the time and feeling off. I'm guessing you had a lean breakfast rather an eggs, bacon, a tomato, cheese, and/or high meat content sausages for instance? Because I can guarantee you, with a meal like that, you wouldn't've been hungry for quite a few hours after. Lunch, dinner.... Fats and protein are your friends there. Don't leave the table hungry. Otherwise it's not going to work in the long run, which you've already noticed. Also, dizzy and lightheaded... If you cut carbs you often also miss a lot of salt from your diet. (As it is in bread and such). My blood pressure went from normal to low once I changed my diet, and I needed to up my salt intake some. Considering your heart issues you might be on blood pressure medication, that could clash with eating less salts and drop you too low, (medication might need adjusting) and if you are on statins, those tend to up blood glucose... With your history you might need them though, but they might be a reason, if you are on them that is, for slightly elevated numbers too. So you have a bit of a puzzle before you, but not anything that can't be solved.

If you can tell us what you used to eat when low carbing, and what you're eating and drinking now, we might be able to tweak your diet with you. The hive mind has a lot of suggestions and experience.

Oh, and if you're interested,


Thank you Jo, so very helpful. I have update a general reply below. Patricia

 

[jpatricia]

Oops, apologies if my response to at least one thread didn't post. Still getting to grips with technology and by the way, repeating myself.
Idea of posting the diet I hav tried is fine if it doesn't bore any one out force run! Patricia

 

[JoKalsbeek]

Oops, apologies if my response to at least one thread didn't post. Still getting to grips with technology and by the way, repeating myself.
Idea of posting the diet I hav tried is fine if it doesn't bore any one out force run! Patricia

The more detailed things get, the better. It's the only way we can find out where things may go wrong.

 

[TeddyTottie]

Hi Patricia, I well understand the misery of appalling digestion and a hiatus hernia, but for me at least, carbs were one of the main culprits, not the cure.

If you feel up to it, having another go at low carb, supported by all the good people here, could well bring you huge benefits. Since going keto I have effortlessly shed over 3 stone in 4 months and ALL my digestive issues have gone. Just... gone. Hiatus hernia is generally much improved by weight loss as excessive abdominal fat increases internal pressures, and the new diet just doesn’t generate the miserable indigestion I previously suffered from.

As others have said, a low carb diet should not be a hungry, unhappy experience. Let us help you...

 

[HSSS]

When you cut carbs quickly it’s not unusual for your body to protest in the ways you describe. It’s called a false hypo. Your body is adapted to high levels and wants to make you stay where it’s accustomed to being. Lowering them more slowly is a gentler option or riding it out til your get acclimatised is the other. Alongside this is the fact that you might simply need more food/energy. Are you increasing fats and proteins to compensate for less carbs?

U.K. Gp surgeries rarely fund testing so they therefore feel the need to justify it by saying it’s not necessary. It’s also because alongside failing to recognise the significant role carbs play they don’t know how to test for type 2 purposes either. We can give guidance if you want to try this for a while. It gives you a really good idea what food suits your diabetes and motivates when you see rapid improvement. But most likely you will need to fund this yourself even if only for a couple of months to get the idea.

Overall you need to balance the risk of high levels and the possible complications and how they effect your life (even just the tiredness at the less damaging end of the scale) against maintaining a fulfilling and acceptable life. Some find the changes in food easier than we think we will and not a sacrifice once we get into it and prefer to minimise complications in the future. Some really don’t want to change are are happy to take some meds and hope the longer term problems don’t catch up with them any time soon. Making an informed choice is the key.

 

[HSSS]

Now I have had bloods taken with the result of a sugar measure of 7.0 (this was non fasting late am), at least there is a current measurement.

If this is a random reading after who knows what food or time it’s pretty meaningless I’m afraid unless extremely high eg in the teens or more. The only ones that mean anything for a type 2 on either no or basic meds are hb1ac (3 month average of levels), a fasting blood glucose test, the readings paired before and 2 hrs after a meal.

 

[jpatricia]

Hi Patricia, I well understand the misery of appalling digestion and a hiatus hernia, but for me at least, carbs were one of the main culprits, not the cure.

If you feel up to it, having another go at low carb, supported by all the good people here, could well bring you huge benefits. Since going keto I have effortlessly shed over 3 stone in 4 months and ALL my digestive issues have gone. Just... gone. Hiatus hernia is generally much improved by weight loss as excessive abdominal fat increases internal pressures, and the new diet just doesn’t generate the miserable indigestion I previously suffered from.

As others have said, a low carb diet should not be a hungry, unhappy experience. Let us help you...

Thank you, just trying to get my head round it all after I've had the telephone consultation with the diabetic nurse hopefully, will be better place to take up all the kind offers. Very scared of failing yet again.

 

[jpatricia]

If this is a random reading after who knows what food or time it’s pretty meaningless I’m afraid unless extremely high eg in the teens or more. The only ones that mean anything for a type 2 on either no or basic meds are hb1ac (3 month average of levels), a fasting blood glucose test, the readings paired before and 2 hrs after a meal.

Yes, I'm confused by the general lack of efficient follow up. My surgery is excellent and I've been there 35 years. However I thought one had to be tested, or self tested every 6 months but I was told annually. The last early am fasting test came back at 6.4,hcb1 September last year. Anyway, I have a stack of questions to ask when I speak to the nurse Wednesday. She has been self isolating due to family problems for 6 weeks. Thank you for your interest. Patricia

 

[xfieldok]

It takes time to get your head around things especially with all the conflicting advice and misinformation out there.

Make a list of your questions in preparation for the phone call. And take notes

 

[HSSS]

Yes, I'm confused by the general lack of efficient follow up. My surgery is excellent and I've been there 35 years. However I thought one had to be tested, or self tested every 6 months but I was told annually. The last early am fasting test came back at 6.4,hcb1 September last year. Anyway, I have a stack of questions to ask when I speak to the nurse Wednesday. She has been self isolating due to family problems for 6 weeks. Thank you for your interest. Patricia

Hb1ac is not a fasting test. Blood glucose is. So the 6.4 could be either, in % or mmol.

NICE guidelines say hb1ac should be every 6 months.

Try the questions out on us first so you know what to expect or have follow up questions ready.

 

[xfieldok]

Try the questions out on us first so you know what to expect or have follow up questions ready.

Good idea.

 

[jpatricia]

You have been through a horrible time and I am sorry for your loss.

You say you have tried low carb but it left you hungry? If done properly you should not be hungry.

Carbs are key to controlling T2. It is a metabolic disorder which means we cannot process carbs.

Would you be prepared to give it another go with our help?

I hope I have kind of replied to you very helpful post. Forgive me if I'm still fairly confused. I'm working on it. Regards Patricia

 

[dipsydo]

I know we are all different but I found that before I went low carb that I was hungry all the time , now I am I find I do not need to snack as low carb suits me . What you could try is moderately low carb and see if it works to reduce your blood sugar . As others have said need to have some fat if you are to avoid hunger and actually it also seems in some people to increase loss of weight . I lost over 4 stone eating low carb and not counting a calorie. I know you have had heart issues so may be worried about fat. The thing you need to look at is that a lot of low fat foods replace fat with sugars so I are not good . I personally avoid things anything which is artificially low fat for example low fat cheeses, yogurt etc. I am not a great fat eater so I boost my fat intake with things like olives, nuts ( in moderation as for me they were the one thing which stalled my weight loss ) and cooking items in oil. As others have said testing to see what agrees or disagrees with you allows you to work out what is causes higher blood sugars.