15.9 reading. Very worried and have lots of questions.

Faar23 said:

Hello everyone,

New member and I don't have diabetes (yet) my husband does, so I hope its it's ok to post here with my questions about diabetes.

He is 35 years old and was diagnosed with type 2 diabetes last year. He is on metformin, 1 tablet after every meal. He is very much overweight at being nearly 120kg and standing at 5'10.

Anyways he checked his sugar an hour ago and the reading was 15.9! He had dinner at...9 p.m and lunch around 1 p.m. didn't have anything in between as he has been trying to do intermittent fasting. He checked at 3 p.m. and it was 13.9 and at 11 p.m. and it was at 15.9 even though he had taken his pill. So I have some questions:

1) does his medicine need to change because this is not the first time it has gone this high after having a meal and taking metformin. Does metformin take longer to work?
2) how much role does food play in controlling t2 diabetes? We are southasian and our diet mostly consists of carbs (think Indian food which has rice and naan bread etc). My father and mother in law both have diabetes and both eat regular Indian food and their readings are usually normal.
3) would losing weight help in reversing his diabetes? Since its quite recent and he was previously in the prediabetic group.
4) what can I do to help him? He thinks this can be managed by food, but I have no clue how to go about this. Can someone guide me to the right place where I can find out about what he can and can't eat. He has stopped eating sugar. No biscuits, ice creams or sugar in tea but he still likes aspartame in his tea and eats fruits. Should we quit that?

Thanks for all your help.

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1. Metformin will have little effect on the numbers
2. HUGE impact. Rice / breads are BAD for blood sugar numbers as they are carbs which are sugars
3. It'll certainly help as that's FAR too much weight
4. His diet needs a complete overhaul. Fruits are NOT good as they are sugars in overload.

You have a lot of work ahead. What was his last HBA1C?

BTW, all the information you need is here. Remember, carbs convert to sugars once consumed and they are public enemy #1 for diabetics. You need to arrest this .... like now. It'll be a shock and it's meant to be to avoid potential complications down the road.

Welcome to the forum You'll find no better resource and it is he who should be encouraged to ask the questions rather than you taking the load.

Faar23 said:

Hello everyone,

New member and I don't have diabetes (yet) my husband does, so I hope its it's ok to post here with my questions about diabetes.

He is 35 years old and was diagnosed with type 2 diabetes last year. He is on metformin, 1 tablet after every meal. He is very much overweight at being nearly 120kg and standing at 5'10.

Anyways he checked his sugar an hour ago and the reading was 15.9! He had dinner at...9 p.m and lunch around 1 p.m. didn't have anything in between as he has been trying to do intermittent fasting. He checked at 3 p.m. and it was 13.9 and at 11 p.m. and it was at 15.9 even though he had taken his pill. So I have some questions:

1) does his medicine need to change because this is not the first time it has gone this high after having a meal and taking metformin. Does metformin take longer to work?
2) how much role does food play in controlling t2 diabetes? We are southasian and our diet mostly consists of carbs (think Indian food which has rice and naan bread etc). My father and mother in law both have diabetes and both eat regular Indian food and their readings are usually normal.
3) would losing weight help in reversing his diabetes? Since its quite recent and he was previously in the prediabetic group.
4) what can I do to help him? He thinks this can be managed by food, but I have no clue how to go about this. Can someone guide me to the right place where I can find out about what he can and can't eat. He has stopped eating sugar. No biscuits, ice creams or sugar in tea but he still likes aspartame in his tea and eats fruits. Should we quit that?

Thanks for all your help.

Click to expand...

1. Metformin doesn’t work on the food he eats. It works in the background and is only a subtle medicine
2. In type 2 it is almost everything. Far more powerful than medication and better for him to control it this way too. No risk of side effects or Interactions And better long term outcomes. Rice and bread are likely a huge part of his issue. The parents may be on seriously stronger medications. What is “normal”. Normal for a non diabetic or normal for an ageing diabetic expected to get worse with time by old fashioned thinking. Some doctors are very unambitious about what is acceptable.
3. Without doubt losing weight would help. With diabetes and almost every other aspect of health.
4. Both of you can learn about how to eat in a way that controls and reverses the diabetes and helps lose weight and probably improve lots of other metabolic markers too. Giving up sugar is good but it’s all carbohydrates that matter not just sugar. There are better sweeteners than aspartame and fruit is best avoided unless it’s just a few berries. Intermittent fasting is good too. Testing is vital so that’s good too.

get him to Join if possible. Read the links I’ve attached below for an good overview of what is happening and what to do about it food wise. Then come back and ask as many questions as you need to.

Intro to T2 and low carb. https://www.diabetes.co.uk/forum/blog-entry/the-nutritional-thingy.2330/
All the things I wish I’d been told earlier https://www.diabetes.co.uk/forum/th...ish-i’d-been-told-at-type-2-diagnosis.173817/

OK, well don't worry: I think if you cut carbs seriously, you will get major improvements.
My blood readings are usually around 6-7, but if I ate rice, chutney, thick sauces and whatnot I would also go up to 10+ easily.
Dhal can also be very bad for blood readings. Potato and chick peas too. All fruit, pretty much, is best avoided.
Milk is bad but paneer is ok, ghee is ok. Cauliflower is good.

Dr Bernstein has a good list you can refer to
Avoid all foods with added sugar or honey such as desserts, candies, and pastries; all foods made from grains and grain flours such as breads, cereals, pasta, and rice; all starchy vegetables such as potatoes, corn, carrots, peas, tomatoes, and beans; all fresh or preserved fruits and fruit juices; all dairy products except for butter, cream, and fermented cheeses.

Hi @Faar23,

Welcome to the forum. There are lots of friendly, helpful and very knowledgeable people on here. I am sure that collectively we may come up with some ideas how to help your husband.

You are correct, many of us T2s here on this forum are on a low-carb or keto diet to deal with blood sugars. Personally, I had similarly high blood sugars as your husband at diagnosis five years ago and they had dropped back to normal non-diabetic levels after changing the way I eat. Many here have had similar experiences.

However, we are all also very different. No two people with diabetes are alike. Some of us can get away with eating more carbs without causing elevated blood sugars, others have to eat fewer carbs. This might be due to how damaged our metabolicsm already is (though some of this can also be reversed with time). Genetics will also play an important role. So, this is probably why your father can get away with having quite a few carbs (and his diabetes won't progress), but your husband can't.

Just also wanted to post the link to a very useful website that has lots of Indian keto recipes: https://headbangerskitchen.com/ Another good website is dietdoctor.com, though less specialized in Indian cuisine. However, they let you search for dairy-free recipes (i.e. no cheese). You also don't necessarily have to sign up, lots of stuff is for free.

Stick with us and feel free to fire awy if you have questions.

Faar23 said:

Thanks for the links. I have just gone through the first one and it seems like...keto is the way to go? Will a keto diet help with this? Are you on keto? How expensive is keto? Because I have just looked up almond flour and its £6 for 500g bag! whereas regular wheat flour (which we use to make roti(type of pitta bread)) is £5 for 10kg! I mean you can't put a price on health, but I am just wondering.

I also checked the other link and will go through it later on, since it has other links. I think just to test out I will give him an egg and sausage breakfast tomorrow and see how his sugar is after a couple hours. Because we have discussed keto for weightloss before but it...seems very very challenging and there is so much cheese involved. I mean people love cheese I know, but...we don't.

Yes his mother and my father are both ageing diabetics. His mother is on insulin and she doesn't really take care too much but my father is on metformin now and he has had t2 for nearly 25+ years now. I have seen what he eats and he hasn't cut out the carbs completely. Like every morning for breakfast he has 1 wholewheat toast with 1 fried egg and tea. For lunch its usually a portion of boiled white rice with stir fried veg and chicken (1 teaspoon oil). When he comes back from work he will have a plate of salad with 1 roti (like tortilla...do you know what roti is?) with a portion of curry (can be veg, meat, chicken or lentils) and then at night time again he will have a snack like piece of brown bread with tea or curry again. So his numbers are usually okay and not this insane. I did ask him what he changed in his food and he said when he found out he gave up sugar, thats it, otherwise there was no change. my mother now makes food with very little oil or no oil but when I was younger and living with her she used to make it with an adequate amount of oil.

I guess I will ask more questions as they come to me but yeah let's see if we can manage this somehow

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Keto is a diet which works best for you (or your husband, as the case may be), if you find, within it, things that you/he actually likes to eat. No cheese? More meat and eggs. Rice is out, but cauliflower rice is fine. And yeah, almond flour (and coconut flour for that matter) are pricey, but there's no law anywhere that states you have to absolutely make bread. I didn't make my first Keto Mug Bread until I'd gone without any kind of bread for 3 years. And now, after a year of the occasional keto mug bread, I can say I make it maybe twice a month? My diet just doesn't desperately cry out for bread. So while a lot of keto foods can get expensive, it's easier to just keep it really simple. Meat, fish, poultry, eggs, cauliflower rice, above ground, non-starchy vegetables, leafy greens, proper butter/ghee, coconut oil, olives, extra dark chocolate... Very few carbs in herbs and spices, usually, so making food interesting shouldn't be a very big problem. Berries are fine. Other fruit, steer clear from. It doesn't have to be more complicated or expensive than it absolutely has to be. As for metformin, it doesn't do anything about what a person eats. It just tells their liver not to dump too much glucose in the morning. There's two sources of glucose in our lives: What we eat, and what our liver makes. So while the metformin takes a LITTLE care about the liver, the bulk of what goes on with our blood sugars is food related. So yeah... The metformin is probably not making much of a dent. And Intermittent Fasting would solve quite a few of the food issues.... It's easier to have one or two meals a day and still be original/creative, than have to make three. Just keep in mind that a lot of the expensive ingredients go into foods that need to resemble high-carb foods... While there's plenty of low carb fare around that doesn't need xantan gum, psyllium husk powder, xylitol, stevia/erythritol blends and what have you... An omelet with salmon and spinach has no need of those things. Keep it simple, then you keep it inexpensive.

Faar23 said:

would losing weight help in reversing his diabetes? Since its quite recent and he was previously in the prediabetic group.

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It's very likely that weight-loss could put your husband into remission as he has only recently become diabetic. https://www.ncl.ac.uk/magres/research/diabetes/reversal/#publicinformation

At this stage, weight-loss is more important than how the weight is lost. Low carbing will generally work for weight-loss but although a lot of people love the diet, other people don't. He needs to choose a diet that he can stick to. Some people prefer to start with a 'short, sharp, shock' such as the Newcastle diet https://www.theguardian.com/lifeandstyle/2013/may/12/type-2-diabetes-diet-cure and https://www.ncl.ac.uk/press/articles/archive/2019/03/weightlosstype2diabetesremissionfor2years/
Other people may prefer to lose the weight more gradually. If he loses a substantial amount of weight (15 kg or so) and hasn't gone into remission, a low-carb diet can help control his blood glucose as all carbohydrates are broken down to glucose by digestion.

Faar23 said:

Thanks for the links. I have just gone through the first one and it seems like...keto is the way to go? Will a keto diet help with this? Are you on keto? How expensive is keto? Because I have just looked up almond flour and its £6 for 500g bag! whereas regular wheat flour (which we use to make roti(type of pitta bread)) is £5 for 10kg! I mean you can't put a price on health, but I am just wondering.

I also checked the other link and will go through it later on, since it has other links. I think just to test out I will give him an egg and sausage breakfast tomorrow and see how his sugar is after a couple hours. Because we have discussed keto for weightloss before but it...seems very very challenging and there is so much cheese involved. I mean people love cheese I know, but...we don't.

Yes his mother and my father are both ageing diabetics. His mother is on insulin and she doesn't really take care too much but my father is on metformin now and he has had t2 for nearly 25+ years now. I have seen what he eats and he hasn't cut out the carbs completely. Like every morning for breakfast he has 1 wholewheat toast with 1 fried egg and tea. For lunch its usually a portion of boiled white rice with stir fried veg and chicken (1 teaspoon oil). When he comes back from work he will have a plate of salad with 1 roti (like tortilla...do you know what roti is?) with a portion of curry (can be veg, meat, chicken or lentils) and then at night time again he will have a snack like piece of brown bread with tea or curry again. So his numbers are usually okay and not this insane. I did ask him what he changed in his food and he said when he found out he gave up sugar, thats it, otherwise there was no change. my mother now makes food with very little oil or no oil but when I was younger and living with her she used to make it with an adequate amount of oil.

I guess I will ask more questions as they come to me but yeah let's see if we can manage this somehow

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keto is great but for some people it’s just too much, too soon. Everything to lower carbs though is beneficial even if you take it step by step. Though for me personally I struggle with “just a little bit” and find all or nothing easier.

you don’t have to buy almond flour or any of the other “replacements”. They can be useful to keep you on track but really it’s about changing how you view what is normal to eat. You don’t have to have a “bread” on your plate. It might be more meat or veg for example. Or using cauliflower rice instead of the real thing. That all said almond and coconut flours are more expensive but you also use less by weight per recipe than normal flour. Online retails can be useful for bulk buying at better prices. ( ie use the real food source and amazon a lot) Again you don’t have to fill up on cheese or any one item unless you want to. Your dad is lucky. My numbers would be way too high on that diet. But we are all individual and that’s why we test to see what works for us. Again what are ok numbers in your book?

You mention oil for cooking . Processed seed and vegetable oils are terrible. Stick with natural fats. Ghee is great, butter, meat fats, olive oil Etc.

What is your husband’s attitude to these changes? It’s all very well him being put on this way of eating by you but he has to stay with it. It has to be sustainable and life long not a fad diet. All the problems will return if he goes back to eating the current way. If you have a history of diabetes in your family it is worth considering if it is beneficial for you to at least partly follow a lower carb way of eating as a preventative measure and for simplicity in the kitchen. My families carbs are on the side” a lot of the time, whereas not required or even missed anymore on my plate.

Hi. The advice to reduce the carbs is the most important thing for your husband but it will be difficult to change the typical diet of his culture; he can only try. I would ask for the Metformin to be increased. The max is usually 2000mg/day which I was on for many years. It doesn't do a lot but is worth having. There are one or two other meds that may be possible but best to do the diet first. BTW a blood sugar finger prick test below 20 is not good but not dangerous in the short-term. If it goes regularly into the 20s then that isn't good and needs further GP help.

It is not uncommon to have rice three times per day (breakfast, lunch and dinner) in East/South-East Asia. 200g rice per meal. Add naan bread or heavily battered meat/fish/onion to this and you have a carb rocket. It is difficult to change this eating pattern by making small changes.

So, I also think that keto-diet is your best option. Exclude high carbs and increase Fats. For example typically I have:

- celeriac mash or cauliflower rice* or cauliflower mash instead of rice/potatoes/noodles
- breakfast 6am, snack 9am, lunch noon, snack 2pm, dinner 6pm
(after dinner 12 hours without food - a bit like 'half' fasting)

Breakfast:
2 mini-bockwursts** OR 2 frankfurters** OR 2 slices bacon +
2 poached/boiled/fried eggs + 50g cheese (cheddar/gouda,...)

Lunch: 2-egg omelette (spinach, tomato, meat/sausage filling) OR
2 zero-carb Angus Quarter pounders (Iceland, LIDL) + cheese slice toppings OR
leftovers

Dinner: meat OR fish + celeriac mash OR cauliflower rice/mash +
baby spinach OR/AND avocado OR/AND broccoli OR/AND Kale

Snack: Cream coffe (instant Nescafe + 3 tbsp double cream) OR
Greek full fat authentic yogurt sometimes with 50g raspberries

I gain about 0.5kg per week on this diet. That is what I want.
Keto diets are easy to modify. Eat smaller portions, eat other foods, skip snacks and so on to reach your weight goal.

* Cauliflower rice: white and grainy cauliflower, it is not rice. You can buy frozen in UK super markets.

** You can enjoy the bockwurst sausage or frankfurter sausage in a Keto Hot Dog bun that you bake using Psyllium Husk and Almond Flour (Ground Almond in UK). Recipe makes about 10 hot dog buns, each only 1g carb.
Link in:
https://www.dietdoctor.com/recipes/keto-hot-dog-buns

resander said:

breakfast 6am, snack 9am, lunch noon, snack 2pm, dinner 6pm

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For those wishing to reduce insulin resistance (The problem behind type 2) adding the snacks to the meals and not grazing would be even better. Allows the insulin to fall between meals better.

Disclaimer as I haven’t watched it but thought it might be relevant. Dr Malholtra is usually on point so sharing hoping he is this time too - he’s talking about the problems with the Indian diet.

Faar23 said:

Okay...so you have pretty much taken out everything from our diet. He does not eat desserts etc. very rarely and in small quantity if he ever does. Also we don't drink fruit juices and such. Um I will do more research and see what can we eat. Is brown rice or bread or flour better or would the effect be the same?

Also this morning as a test I gave him a cheese omelette with tea but with only a little bit of milk and 1 piece of wholewheat toast and it was all made in butter and 3 hours later when he checked his sugar it was 9! which is a huge improvement from yesterday but still within the high range. I was really encouraging him to not eat the toast but...Guess I will try again tomorrow with eggs and sausages and tea and see if its any better. Baby steps you know.

Another thing I forgot to mention was that he has psoriasis as well and he has had that for 5 years now I think. It's a skin condition. So he is on acetretin, would such a diet have an effect on his skin?

Lastly, speaking to him about this he was saying would his cholesterol level go high if he eats such a high fat diet?

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Brown anything is just as bad as the carbs are much the same. Better without toast but as you say at least it’s improving. Consistency will also help the numbers come down over time.
There are reports that low carb helps psoriasis so that would be another plus point. It helps many inflammatory based conditions. I don’t know about the medication so check the leaflet.also high blood pressure if that is another part of the metabolic syndrome he has. (Any meds for this might need reducing if he sticks to it)

Most of us find cholesterol improves without carbs despite eating more fats. . Fat is not what raises it (Carbs again are the culprit) as much recent research is proving. And it is ratios and which parts of cholesterol that matters. Not the total which is meaningless anyway. Lots of info here on this topic if you want it we can direct you to it.

Faar23 said:

Okay...so you have pretty much taken out everything from our diet. He does not eat desserts etc. very rarely and in small quantity if he ever does. Also we don't drink fruit juices and such. Um I will do more research and see what can we eat. Is brown rice or bread or flour better or would the effect be the same?

Also this morning as a test I gave him a cheese omelette with tea but with only a little bit of milk and 1 piece of wholewheat toast and it was all made in butter and 3 hours later when he checked his sugar it was 9! which is a huge improvement from yesterday but still within the high range. I was really encouraging him to not eat the toast but...Guess I will try again tomorrow with eggs and sausages and tea and see if its any better. Baby steps you know.

Another thing I forgot to mention was that he has psoriasis as well and he has had that for 5 years now I think. It's a skin condition. So he is on acetretin, would such a diet have an effect on his skin?

Lastly, speaking to him about this he was saying would his cholesterol level go high if he eats such a high fat diet?

Click to expand...

My cholesterol dropped significantly on a low-carb diet. Too much starch gave me fatty liver and very high triglycerides. I needed to lose a lot of weight, so I reduced the amount I ate greatly. In a typical day I would eat:
Breakfast: two boiled eggs or some tinned fish
Lunch: a decent sized amount of meat, eg two pork chops or a big piece of salmon with a fairly large amount of green vegetables or cauliflower
Evening meal: alternative version of lunch- if I had pork and cabbage for lunch, I would have fish and cauliflower for my evening meal.

I lost 40lbs and went from incredibly high-cholesterol to normal cholesterol, and from diabetic blood levels to non-diabetic.
Later, I got lazy and started eating starch again- my weight, blood and cholesterol issues came back, albeit in a less severe way.

Faar23 said:

Thanks for those links. I will show him and I am not sure if he can maintain such a drastic calorie deficit because he does work full time and switched careers completely (from railway to IT) so he is still in the learning phase of it and can't really afford to not give his 100% at work just yet. But yes weightloss is definitely something we need to do.

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He doesn't need a calorie deficit. That's one of the reasons why you up the fats. With calorie deficiency he'd probably end up malnourished and hungry all the time. He doesn't have to eat less far as portion sizes go, just ditch the carbs. No toast, just an extra egg or something?