Blood sugar hard to stabilise

carilina

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Hello :wave:

I am having a great deal of trouble trying to get my blood glucose to stabilise. Gliclazide seems to make me feel very ill but my doctor wants me to take it.

She's recently given me a bg monitoring thingy which I've found very useful.

With 2 metformin twice a day my readings over two days are like this:
8 - 6.7 - 9.1 - 8.5 - 7.1 - 7.7. 7.8 - 9.2

With Gliclazide - 1/2 tablet taken twice a day over two days I get this:

11.3 - 10.8 - 4.7 - 11.6 - 15.2 - 6.3 -5.9 -6.8 - 9.1 - 13.7 - 10.6 - 7.1

With Gliclazide my bg seems all over the place and one minute I feel very cold then I feel warm and shaky then cold and achey and weak. When I was first diagnosed nearly 3 months ago my bg was 24 so it's come down quite a lot but I was shocked to see it at 15.2 with a ketone warning yesterday.

Any help or advice would be gratefully received please. :(
 

xyzzy

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Hi Carilina

Without knowing when those readings where taken and what you were eating then its going to be pretty difficult to advise.

If you post up readings taken 2 hours after you've eaten and an idea of what you ate then I'm sure lots of people will be able to help.

The guidelines say that at that 2 hour after eating point you should be trying to get readings under 8.
 

carilina

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Hi xyzzy and thank you for replying,

This is an example of what happened yesterday:

Before breakfast = 9.1
After breakfast (porridge) with 2 metformin and 1/2 Gliclazide = 13.7
Before lunch = 10.6
After lunch (plate of veg only - sprouts, brocolli, cauli, asparagus with some mint sauce and a bit gravy) = 7.1
Before tea = 8.1
After tea (7 strawberries with a piece of brie) with 2 metformin and 1/2 Gliclazide = 6.0
Bedtime (very hungry, had 2 digestives with peanut butter) = 6.3

Basically I am afraid to eat anything and I decided to eat very little yesterday to see what happened with my bg. From lunchtime onwards yesterday after eating just veg and then strawberries for tea I felt very cold and weak and achey.

This morning:
Before breakfast = 10.6
After breakfast (porridge) 16.0 with ketone warning - 2 metformin (didn't take Gliclazide) :(
Before lunch (bag of french fries and half can of semolina) 14.0 (took the half Gliclazide)

I only seem to feel ok once a day and that's when I have porridge for breakfast...from lunchtime onwards it's a downhill slippery slope to feeling ****. Maybe I should just eat porridge 3 times a day and nothing else?

I just don't know how I should be trying to control this horrible condition - I feel so demoralised because even when I take the medication and try to eat sensibly my bg is all over the place with ketone warnings. When I was diagnosed 3 months ago with a bg level of 24, the doctor did a ketone test and it came back clear...so now it seems that with medication and sensible eating I'm still getting the ketone warnings. :(
 

Grazer

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To be honest, I'd go back to the doctor with your results. Ketone warnings with high BG isn't great. You may need different meds, or re-assessment of your type of diabetes.
 

xyzzy

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Yes tend to agree with Grazer. I can see why you may be getting high BG's but why you are getting a Ketone reading is not clear so you need to go talk to the doctor about that. Apart from that...

If what you've listed is a pretty average day then the only thing "bad" you ate yesterday is the porridge and even then some diabetics get away with porridge. You say you think things go astray after lunch to me it looks the other way round. When you ate the porridge for breakfast you get a big spike so 9.1 to 13.7 yesterday and 10.6 to 16 today. After recovering from the spike yesterday your levels were pretty much as you would expect. Your lunch was veg only so very low carb and your tea had some sugar in the strawberries but not a massive amount so your levels came down.

To be honest if you weren't reporting a ketone reading I'd just say stop eating porridge and find something different for breakfast like an omlette or even something like toasted Burgen bread with something on it. I notice you didn't eat any meat. Are you a vegetarian? If not meat is perfectly ok especially white meat like chicken. If you are a vegetarian then others maybe able to advise.

Just noticed you ate a bag of chips and semolina. Bet your 2 hour reading was through the roof after that! Hasn't your doctor or nurse told you to try and restrict starchy foods? They will spike you horribly no matter what meds you take and can be just as bad as eating sugary things. Try cutting down (half) starchy foods like rice, pasta, potatoes, bread and cereals. Replace with eggs, cheese, veg & meat so you don't get hungry.

I maybe wrong but I get the feeling you think your meds should be doing more to help your BG's. The trouble is Metformin will only reduce your levels by 1 or 2 at most. I don't take Glic but know its a stronger med but no way is it going to cope with a bag of chips!
All diabetic meds can only do so much and sorting out what you eat works loads better than any drug imo.

When you joined here did you get Daisy's new member info? If not look here I'm sure Rob wont mind sharing. :) http://www.diabetes.co.uk/diabetes-forum/viewtopic.php?f=39&t=29406. That one has Daisy's info and some stuff I tell new people with some other useful links.

Don't forget about seeing the doc about those Ketone readings...
 

jopar

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Err

Did you actually check your Ketones levels, when your meter gave you a Ketone warning?

As a lot of meters are pre-programmed to flash a ketone warning if it the BG is 14mmol/l or above it doesn't mean that you've actually got ketones, just that you have hit the blood levels that your body can start production ketone of the type that can lead to DKA... So you need to check either by using ketostix in your urine, or if you've got the right meter which able to take a blood test for ketone (got to have the right test strip)...

Can I ask, why you didn't take your glitz with your breakfast when your levels were high!

Porridge is low on the GI index, so the carbs are pretty slow burners... so it could be keeping your bg more stable over the morning, rest of the day you eating pretty low carbs.. Your morning reading are a lot higher than your afternoon/evening ones what could be happening because you've newly diagnosed, is that your morning levels are more akin to what your body had become accustomed to running at, your afternoon/evenings your body perceives as running below your 'normal' levels hence why you don't feel good as your body does need time to readjust it's self to running at lower levels nearer to the normal range...

If you can sort out your morning levels and get the whole day running at normal/near normal range, you probably find that the icky feelings will sort themselves out..

So looking at what changes you can make at breakfast, perhaps smaller bowl of porridge or a change so that you having more protein than carbs will do the trick..
 

carilina

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Darn it, that's bad news that it could be the porridge that's causing problems. It's the only meal of the day I like. :(

I do eat meat but I've really lost my appetite lately - maybe it's just a mental block thing cos of not knowing what to eat. When I say I had a bag of french fries I meant the walkers crisps things rather than a bag of greasy chips.

I just seem to have got it into my head that the Glic is making me feel ill, which is why I didn't take it with breakfast. I'd had a rough two days so tried to do without it. When my doctor gave me the bg monitoring machine she told me to ring the surgery if my bg went over 10 and I knew that if I phoned her she'd just tell me to take the Glic anyway, so I did - besides it's Sunday and she wouldn't have been there anyway. One Glic tablet seems to be too much in one go which is why i'm just taking half. So, anyway, I took the Glic late morning and had a terrible bout of the runs and my bg went right down to 7 then 6 then 4 and I started feeling very shaky so I ate a toffee and it shot back up to 11. :( I don't know whether it's ok to take another half a Glic this late in the day in case I have a hypo when I'm asleep so now I'm fretting about that! I suppose my bg level will be very high again in the morning.

I'm also testing so much that I'm finding it difficult to find places to get blood - my fingers are sore and the blood hardly comes out and now I'm wasting the testing strips/lancets cos of getting error messages. Basically whenever I feel different I test because I really want to learn what my bg levels are when I feel odd at various times of the day so that eventually I'll know what's wrong with my bg without needing to test - hopefully!

Once my bg levels rise then the nerve pain kicks in too which keeps me awake. Bonus. :crazy:

Anyway, thank you for your comments, I will take the time to read them again tomorrow and see what changes I can make. Clearly I need to think a bit more about what I'm eating. I do feel exhausted and very tearful with it all but I guess you've all been through it.
 

angieG

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Try having a different breakfast in the morning and see what that does. Maybe try eggs or a yoghurt or something just as an experiment.
I know it means missing the porridge but if you feel better for the rest of the day surely that is a small price to pay?

If you can get your levels down to reasonable figures you will be able to quit with the Glic most probably as it's often only used initially to bring high levels down.....I know I was on that roller-coaster once too coming down from a diagnosis at 25!!

Good luck, it is all trial and error I'm afraid.

Angie
 

xyzzy

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The reason you feel bad when your levels drop to 6 or 7 is because your body has got use to running at a too high level and is moaning "where's" my sugar!

After you eat the guidelines say you should end up under 8ish after two hours. At all other times the guidelines say to try and keep your levels between 4 and 7 as that is the range a non diabetic would be at. That's why your doctor is rightly concerned about your levels being above 10.

It can be difficult to get your levels down but you should try as being regularly above 8 is where you will begin to run high risks of damaging yourself. If you feel bad then rather than give into the sugar "cravings" try eating something like a few ritz crackers and cheese or a piece of brown bread or some nuts or even a few "berries" mixed with some plain Greek yoghurt. These kind of things will give your body a little bit of a hit that should stop you feeling bad without giving in to its demands for sugar. After a while the bad feelings will begin to go and you'll be amazed at how much better you feel.

It is difficult to start with all this giving up stuff mostly cos what you're giving up is what most people are use to eating. The problem is you don't see any immediate consequence of eating the wrong things. If that bad of chips immediately sent you blind for half an hour you'd think twice about eating them again wouldn't you?
 

carilina

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Thank you so much for all your comments which I am taking on board.

I did take a quarter of a Glic before bed last night and woke up with a 9.3 reading which was better than the last test which was 11.4 - usually I wake up with a reading that is higher than my last test, but this time it was lower. I think it's finally sunk in too, thanks to jopar, that I have to get my morning bg under better control so I did take a whole Glic this morning an hour before breakfast. I then tested again before breakfast and my bg had lowered slightly. I will find it very difficult to give up porridge so I had a smaller portion this morning and will see what effect that has when I test again in an hour or so. If it's still not good then I will give it up and try something else.

It's only been since I had this blood monitoring machine that I've been able to see what's going on and can now try to do something about it. My doctor told me to test just once a day, in the morning, but I don't think that's enough at the moment. I needed to see for myself what was happening especially the effects of what I am eating - which has clearly not been good enough.
 

carilina

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Finally I think things are starting to sink in and realise that it's not the tablets that are making me ill but what I eat when I take them.

The variation in breakfast alone has now given me a reading of 7.5 two hours after breakfast whereas normally I'd be looking at 10-16 with a ketone warning. That is the best post-breakfast reading I've had so far!

You have all given me some very good advice and spelled it out, which is just what I needed, because I honestly didn't realise what was happening to me nor how to make things better but now I feel that things are starting to sink in and I can try to take control rather than thinking it would be the drugs that did the work...or made me feel so ill.

Thank you very much :thumbup:
 

catza

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That is a great reduction carilina. If you still want to have some porridge occasionally then it can be made by using a mixture of oats and Almond flour. It has cropped up on the forum before and this is a link to one of the posts swimmer2 made.

viewtopic.php?f=25&t=28584&p=265351&hilit=almond+flour+porridge#p265351

Personally I can't have porridge for breakfast as it sends my figures far to high but the alternatives are great. Who would have thought you could have bacon and eggs or an cheesy egg omelet and get a low reading. Even more miraculous is that you can loose weight whilst enjoying such tasty breakfasts. :D Low carbing certainly works for me I just wish I had discovered it years ago.

You mentioned feeling ill and I can certainly sympathise with you on that. I still have the odd wobble but now know that it just means my body is complaining, so instead of the Mars bar I would have eaten my body just has to make do with a lump of cheese or a couple of walnuts. :D
 

hanadr

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Carilina
managing diabetes is a learning process. You need to learn the things which apply to everyone, the things that apply to diabetics, the things that apply to your particular form of diabetes and the things that apply to you personally. it's a LOT and it takes time.
as with everything, the longest journey starts with the first step and you've taken that. :D
Hana
 

xyzzy

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Great news Carilina glad you've seen such a quick improvement. Now apart from sugar which all diabetics know about then just remember to cut down as much as it takes on the next culprits which are rice, pasta, potatoes, bread, cereals and anything else made with flour. Do that enough and your levels will normalise. Yes its going to be difficult BUT don't think of it as a diet so eat as much of other stuff as you want to not get hungry especially at the start. For lunch today I had bacon, egg and mushrooms so its not all bad!
Try swapping to brown or tri colour pasta, brown rice and get Burgen soya bread if you can. If you eat potatoes try and restrict to a couple of boiled potatoes or better still eat roast potatoes, mashed potato is probably the worst thing a diabetic can eat and ranks alongside eating a handful of sugar. Eat as much veg as you can handle. Try to eat veg that grows above ground as any that grow below may be starchy like potatoes. Try and drink a good amount. If like me you really can't face drinking loads of water drink diet coke or similar. As long as what you drink is "diet" it should be fine.

Don't feel bad about going out every so often and having a good time but on normal days try and remember the "rules".

If you need help then just keep asking. If you get a bad reading then do what others do and post up what you had in the meal and loads of people will help you.
 

carilina

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I can't believe the difference today just by having a smaller portion of porridge!

9.3 bg on waking followed by 8.8 after I'd taken a whole Gliclazide, then 7.5 after breakfast followed by 4.1 before lunch (which was a salad with a boiled egg and a bit of cottage cheese and a banana) then 5.2 after lunch. I felt quite shaky when it was at 4.1 which is my lowest ever reading and why I had the banana. It was then 8.6 before tea and before taking the second lot of metformin, so I'll check it again in a couple of hours to see what it's like then. Pretty good readings today, but I still have to get it down to under 7, is that right?

The best bit is that I haven't felt cold all day and not nearly so achey and weak either. Sometimes I get so weak that I can barely stand and walk, but today has been much better. And that is because of having porridge for breakfast? Blimey! :shock:
 

Topsec

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Great results there, isn't it fab to see them tumble when we start eating the 'right' things :)

Just a side note, banana's are not good :( One of the worst fruits there is which is a shame as they are so yummy! My hubby (T2) had his first banana yesterday in months which we shared - we were on the road in Texas which is a baaad place to try to find low carb snacks!!

As mentioned, go find some Burgen Soya and Linseed bread, low carb and really tasty too! Are you making your porridge with milk or water btw?
 

xyzzy

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carilina said:
I can't believe the difference today just by having a smaller portion of porridge!

9.3 bg on waking followed by 8.8 after I'd taken a whole Gliclazide, then 7.5 after breakfast followed by 4.1 before lunch (which was a salad with a boiled egg and a bit of cottage cheese and a banana) then 5.2 after lunch. I felt quite shaky when it was at 4.1 which is my lowest ever reading and why I had the banana. It was then 8.6 before tea and before taking the second lot of metformin, so I'll check it again in a couple of hours to see what it's like then. Pretty good readings today, but I still have to get it down to under 7, is that right?

The best bit is that I haven't felt cold all day and not nearly so achey and weak either. Sometimes I get so weak that I can barely stand and walk, but today has been much better. And that is because of having porridge for breakfast? Blimey! :shock:

Well there you go! Well done. :clap:

Yes but be a bit careful with the Glic. As its an insulin stimulating drug you probably will need to eat some carbs when you take it or you could drop too low. You did the right thing when you felt shaky and ate a good choice with the banana to get your levels back up a bit without filling yourself full of pure sugar.

If the Glic is working that well at stimulating your insulin response you MAY be able to give it up entirely if you keep your carbs low enough. I just take Metformin (3 x 500g) as do many others. If you want to do that then you really HAVE to commit to a low carb lifestyle as otherwise your levels will be too high. The advantage of giving up the Glic is two fold. Firstly it will allow your pancreas to have a nice rest (so long as you keep low carb) which many think is a good thing and secondly you won't be susceptible to going too low as Metformin cannot take you too low in all but the most extreme cases. Obviously discuss with your doctor before changing your meds.

As to levels you should be aiming for under 8ish two hours after eating a meal and at other times of the day to be between 4 and 7. If you can achieve that then you will really minimise the risks of complications occurring later down the line as effectively you will be running your levels at roughly the same as a non diabetic. Not a cure though as you will still need to eat low carb (or go back on higher strength meds) if you start eating more carbs again.

Keep those questions coming!
 

MaryJ

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Goodness caralina

Brilliant results.

Well done, as xyzzy says you need to watch the meds now as you are going to need less glic or risk going too low.



Mary x
 

carilina

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I've been making the porridge with half each of skimmed milk and low fat milk. If I had to make it with just water :thumbdown: I would be able to give it up no probs - having said that, with the brilliant results I've had today, then I think I will just have porridge a couple of times a week rather than every day and try something else other days.

As I said earlier my bg level was 8.6 before tea and it was 6.5 two hours later. I find it incredible that it actually went down rather than up! And all because I started the day properly it's had a knock-on effect all day. The only reason I had the small banana was because I was feeling shaky and my bg was down to 4.1, which is the lowest it's ever been since being diagnosed.

There are a few things that I'm still unclear about.

What is the difference between a non-diabetic being able to eat porridge and a diabetic not being able to eat it? What is the difference between being non-diabetic and being diabetic? What is it about carbs that makes the bg level rise? Maybe if I understood it all a bit better then it would make life a bit easier.

What does the Glic do that makes me need to be wary of it? Maybe I should go back to just half tomorrow and see what happens? I did go a bit low today (for me) but apparently 4.1 is still within a good range and I probably didn't need the banana - but I was just about to go out in the car and the doctor said I should always test before driving and not to drive if my bg was under 5.

What does the metformin do?

Have just done my final test for today (4 hours after tea) and it's gone up a bit to 7.5.
 

angieG

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Glad you are solving your problems :)
The carbs turn to sugar and so push your bg levels up.
The Glic makes you produce more insulin from your pancreas so it can make you go too low.
You were right to eat the banana before driving as Glic is a bit risky when driving as it can pull you too low too quick when you are getting good figures, always best to make sure and be safe.

As for the porridge, try making it with water and then stirring in a little double cream when it is ready. The cream is lower carb, will add flavour lost without the milk and the fat content will help keep any spikes lower (that's if you don't mind eating a bit of fat).

Keep up the good work, well done :clap:
Angie