T2 Not Going Downhil Quite as fast as before!!!

[AndyH1]

In my first post, I was worried that my condition had worsened and I was on the road that led to insulin. This was due in particular, to excessively high fasting BG levels (over 10mmol/l) I had been but on 2 x 30mg Glic and 5mg Linagliptin.

Since then I have followed the advice on here, and experimented with my diet and done lots of testing. I now know the main culprit is starchy carbs in the evening, even healthy starchy carbs like baked spud or wholegrain bread do it..

So I can now get my post prandial levels down to an acceptable level. The problem is my fasting levels are still, on average 2 mmol/l higher than my post prandial. This is almost every night, whether I have starchy carbs, low gi carbs (beans, chick peas etc) or even no carbs with my evening meal. Wine seems to have a favourable effect on my post prandial level, but still get that over night rise.

The good news is my GP feels I am still T2 and that we have some wiggle room with the current meds. So I have avoided the referral to the hospital diabetic specialist.

We have changed the timing of some of my meds in the hope that it might help. I now have the linagliptin with my evening meal and my last Glic tablet when I go to bed.

There is scope to increase the Glic, but I do a lot of exercise (not quite sure I'd call it sport) and am concerned about the possibility of hypos, and obviously both my GP and I feel it is important to keep the exercise up.

The other night, my post prandial was 4.6mmol/l, got a bit concerned that it was to low to got to bed on so had small snack (couple of crackers and few crisps, about 10g carbs). Next morning my fasting level was 10.0mmol/l.

Still at least feel a bit more optimistic that I can delay the need for insulin for a while yet. Got to see the GP in three weeks again.

The help and advice on here has been very useful.

Andy

 

[Karen.G.]

Well done Sounds like you are on the road to success

I quite agree - this site has been a godsend!!!!

 

[Yorksman]

Are you losing weight?

If you are not eating carbs, this can show up in low post meal readings. But, when you fast and start to get near 4.o, your body will get the glucose it requires from stores of fatty acids, a sort of intermediate stage between glucose and stored fat. Hence, even though you haven't eaten any carbs, your BG does go up, except in this instance, it is from your body. The high fasting readings you get will come down eventually, as long as you don't top your carbs up by eating too many of them and, once you have used up some of the fatty acids in your liver and pancreas, things should start to come down. Then, your body will start to look at other stores to make up the glucose that it needs. The process is called gluconeogenesis and is the generation of glucose from non-carbohydrate carbon substrates such as pyruvate, lactate, glycerol, glucogenic amino acids, and odd-chain fatty acids.

Have a look at the paragraph on biological processes in this wiki article on homeostasis.

It is normal, your body is having to look for its own supply since you are not obliging it by eating much.

 

[xyzzy]

Agree with Yorkman. You should see a gradual improvement in pre meal readings as you continue reducing the starch as your glycogen reserves will begin to deplete. The same effect will help dawn phenomenon as well. When it does start to happen be prepared to go back to the docs on advice on reducing the meds or you'll start to run a hypo risk

Sent from the Diabetes Forum App

 

[AndyH1]

Thanks for the replies. Sadly, I can't say that I'm losing weight. Although not overweight I would mind dropping a kilo.

What you say seems to make sense, but of course no way of knowing. Things are settling down a bit. I think the reduction in carbs has had a drastic impact. Currently on a liberal/moderate carb diet with the odd low carb day, that's not really planned. Just a natural consequence of drastically reducing my starchy carbs and either not replacing them or having something much higher in fibre.

Also changed strategy a bit. Because I get regular night time rise of about 2.0mmol/l I now try and achieve a post prandial of below 6.0mmo/l to allow for it.

Also keen to reduce meds again if possible. I'm aware of the hypo risk. Seem to be ok with cycling and running for up to an hour or 1.5 hrs swimming. Yet to try anything longer on new meds. Also aware that these meds are working my pancreas harder, and as such may lead to insulin quicker.

Andy