First Drugs

[TB10]

Diagnosed 3 years ago with T2. Managed diet control, but last January HBA1c crept up to 49. Cut down even further on carbs and tried to lose a little weight ( BMI =27), but lockdown didn’t help. Just had another HBA1c and now 51. I’m expecting to now have to take drugs, but hope I can manage with non hypoglycaemic ones for now as I’m a pilot and can keep my medical on non hypoglycaemic drugs. Feel I’ve lost the battle, what should I expect to be prescribed.
Tony

 

[bulkbiker]

Try a pure carnivore diet?
I'd say it's fairly unlikely you'll even be prescribed as 49 to 51 mml/m could well be the margin of error between two lab tests.

 

[Antje77]

Cut down even further on carbs

Hi @TB10 , and welcome to the forum!
Could you tell us what you eat and drink on a usual day? It might be you've overlooked some things, like most of us did at the beginning.
With a hba1c of 51 you're only just in the diabetic range. First drug to be offered is usually metformin, which doesn't hold the risk of hypoglyceamia as a rule.

 

[TB10]

Hi @TB10 , and welcome to the forum!
Could you tell us what you eat and drink on a usual day? It might be you've overlooked some things, like most of us did at the beginning.
With a hba1c of 51 you're only just in the diabetic range. First drug to be offered is usually metformin, which doesn't hold the risk of hypoglyceamia as a rule.

Thanks that’s helpful.
Normal day. 1slice toast at breakfast, fish or chicken salad at lunch and decaf coffee. Fish or chicken with green veg at night. I don’t eat red meat and only white fish. No sweets, snacks or potatoes. I do have a glass or two of wine in the evening and a green Apple possibility twice a day as a top up.
I check my blood( have to as a pilot) usually around 6.5-7 2 hrs after but mornings much higher. I walk at a pace 4 miles every day.

 

[Antje77]

Would it be an idea to not eat the toast in the morning? You say your morning numbers are the highest, perhaps the morning is not the best time to add those carbs from toast to already high blood sugars?
Do you by any chance like bacon and eggs?

With the apples, I'd test before and after to see how they affect your blood sugars. Personally, I prefer things like cheese to top up in between meals, as I would have to inject insulin for an apple.
From what you list it looks like you eat very little fat in addition to not eating many carbs. Are you on a low calorie diet to lose weight?

You might like to read this by one of our members: https://www.diabetes.co.uk/forum/blog-entry/the-nutritional-thingy.2330/

 

[TB10]

Thanks so much for the suggestions:

Yes I could ditch the "Toast" and go for a low carb cereal, I think they exist. I've really difficult diet issues, allergic to cheese and can't eat bacon or other red meats due ethnic reasons. I will review the post you suggested. Not really on a loose weight diet, its just what I like I will experiment with the apples as well. I guess the toast is a comfort thing, as you say not much else fat or carbs in the diet.

 

[Antje77]

Allergic to cheese and no red meat does complicate things. What about a nice juicy chicken leg for breakfast?
Or a full fat Greek yoghurt?

 

[bulkbiker]

other red meats due ethnic reasons

Could you elaborate.. I'm quite interested in why ?

 

[TB10]

Ok I’m afraid yogurt comes in the same category as cheese. The most I can tolerate is a few teaspoons of skimmed milk a day. I shouldn’t eat any meat, not properly sourced as I’m a practising Jew. There are no sources locally so I had to comprise and eat chicken purchased locally. I could chew a chicken leg for breakfast, but it doesn’t appeal! Have you any thoughts about my overnight, I think it’s called the dawn effect. Years ago my GP said it was something like impaired fasting glycemia, but he retired and that got forgotten. I’m 10/11 in the mornings falling to around 5.5 after my first walk ....and the toast !

 

[HSSS]

Definitely find an alternative to the toast as this seems your most vulnerable part of the day. I make this without the chocolate https://www.ditchthecarbs.com/chocolate-grain-free-granola/ and mix and match the seeds and grains with whatever I have. And there’s nothing to say it has to be traditional breakfast food. I often eat leftovers for breakfast.

Do a search for dawn phenomenon on here. Some find a late night snack of fats, or proteins, fools the liver into not need8ng to dump glucose as badly. I’ve found eating even just a small cube of hard cheese (Or anything more or less zero carb) when I rise puts a stop to it. Finding something that prevents this morning high would make quite a difference to the hb1ac by the sounds of it.

oh and I was diagnosed at 55 and didn’t have meds and maintain a low 40’s with no suggestions of meds of any kind.

 

[EllieM]

How about a small can of tuna or or some smoked mackerel or salmon? (Trying to go for things that you don't have to cook.) Eggs are always good, you could have hard boiled ones as a snack.

 

[MrsA2]

90 second mug bread maybe your answer for the mornings. Plenty of recipes on Internet but I just melt a bit of butter or oil in a mug or microwave container about the size of an ordinary piece of .bread. then throw into it 2 tablespoons ground almonds 1 tablespoon milled seeds and an egg.mix together and cook in microwave 90 seconds.
Its a bit drier than wheat bread but cover it in butter and its fine.
Can vary it with different seeds or nut to seed ratios, add herbs, spices or flavourings. Can toast it too.
Hope it helps. Would be interested to hear how it goes

 

[Tophat1900]

Check out the link @Antje77 supplied, it's also in my signature line and a number of other people carry it to offer to people needing dietary help. It's great advice.

I'd agree, ditch the toast, no point eating cereal as an alternative as they are just as bad or even worse then toast. As @EllieM suggested, go for something that doesn't need to be cooked. Makes it quick and simple. Eggs and fish are certainly not a burden on the pancreas, unlike anything made from grains such as toast and cereals.

I wouldn't be too concerned about a rise from 49 to 51, that's margin.... but I'm sure you can lower it. Good luck.

 

[ianf0ster]

If you can't eat cheese, then eggs(boiled, fried, scrambled or as an omlette) are a great alternative.
Only eating white fish - rather than fatty fish such as salmon, tuna, trout, mackerel is also a limitation. You can't give up Carbs long term without increasing Fat at least a little, even if you are trying to lose weight.

So look out for natural foods high in both protein and fat:
Eggs are one of the most complete foods available. Chicken liver is also good though slightly less nutritious than red meat liver.
Eat chicken with the skin on rather than the (too lean) chicken breast.

Eat low carb fatty nuts such as Brazils (not cashews) and low carb fatty fruit such as Avocados and Olives.

I'm sure that you can get your Blood Glucose down this way, without needing to resort to Metformin, since you are barely beyond the pre-diabetic range.

 

[TB10]

Actually I do eat all those fish you mentioned. I was trying to say I don’t eat shell fish. Thanks for the other tips. I can increase eggs also. Is there any rule about food and bad fruit in general.

 

[HSSS]

Actually I do eat all those fish you mentioned. I was trying to say I don’t eat shell fish. Thanks for the other tips. I can increase eggs also. Is there any rule about food and bad fruit in general.

Stick to just berries and not too many. Fructose in fruit adds to fatty liver issues and make the whole insulin resistance issue worse as well as any carbs the fruit might have. https://www.dietdoctor.com/low-carb/fruits. That site has loads more useful resources so take a good look around it