1st appointment with diabetes nurse tomorrow

[nabilla]

Hi, I found out I have prediabetes (HBA1c only 42) 3 weeks ago. Since then, I've been on a lower carb med diet with carbs sitting between 50-80g from day to day. I've cut all milk chocolate but have had two 10g squares of 90% Lindt in that time, straight after a meal. No alcohol or refined sugar and no white/starchy carbs. In fact most carbs are coming from low starch veg, nuts/seed I think.
I've also been checking my blood sugars, to start to get a feel for how food affects me. I should also add I've been quite sick the past two weeks at least with a bad chest infection and low B12, taking strong antibiotics and steroids the past 4 days.

BGM Ranges
Waking 4.8 - 5.4 (I believe this is in the normal range for non-diabetics)
Before lunch = 4.9 - 6.8
after lunch = 5.5 - 11.1 (although the 11.1 was a one-off)
before dinner 5.2 - 13.2 (13.2 one-off, but lots of readings here are above 7)
after dinner 5.8 - 8.5

**sometimes my readings fall after dinner from the pre-dinner reading but I have no idea why**

**tonight, my reading was 7.4 before dinner and 7.4 after dinner - I know there's some good i this in that my food didn't increase my sugar levels (roast chicken, brocolli, chia seeds, some apple strawbs, full fat greek yog and brazil nuts - all weighed). However, it also means my reading was above normal before dinner. I had a lunch of mozarella, tomatoes, basil and EVOO at 1pm and ate dinner at 7pm. Can your sugars rise if you leave too much space between meals??

39% of all readings are 7.7 or more
61% of readings are 4 - 7.7
highest = 13.2
lowest = 4.8

This isn't really enough to start getting to grips with things, but I'm sharing because I'm not sure what to discuss with the nurse:

1) I can see some pre-diabetic people have had bad experiences telling health professionals the use BGM. I'm wary of telling the nurse. Is there any benefit in telling/not telling? I'm also planning to do a trial of the libre 2. Is it worth asking the nurse for support with this (I know I'll need to pay). I want to know if it's normal that I'm still seeing a third of my readings as out of range despite never eating more than 85g carbs a day and eating no white or brown/starchy carbs except trying 3 half baby potatoes and two tablespoons of rice, neither of which resuted in a bad reading. I've found I'm happy without these things anyway, which has been a surprise.

2) I've been doing the Michael Mosley plan but not fasting yet as I'm ill. I think I will tell her this, but again I'm a little wary, expecially as I've not been eating any Potatoes, bread, rice, pasta, other starchy carbs. My taste buds have adjusted quickly and everything tastes super sweet, including water (??). I'm regular as ever and the gastric issues that took me to the doctor in the first place (stomach cramping, blood in stool followed by positive qfit, feeling like a sick child after eating crisps or chocolate). I am still fatigued and my vision changes from blurred to pretty good though.

3) I'm interested in getting a C-peptide test, as suggested by a member here when I was wondering whether I might have an unusual form of diabetes and might raise this. Any tips in doing so much appreciated.

4) Anyone got any other ideas of questions I might ask or ones to avoid asking? I'm very keen to get this under as much control as I can, but I'm aware one of my triggers may be chronic stress and I'm unsure of how to address that.

Thanks!

 

[Antje77]

taking strong antibiotics and steroids the past 4 days.

Infections (for which you are currently taking antibiotics) and steroids are known to raise blood glucose quite spectacularly.
I wouldn't draw any conclusions to your daily BG readings until at least a week or so after your chest infection and last dose of steroids have gone, and I'd definitely not trial a libre while still fighting an infection or taking steroids. It will only show you how illness and steroids affect you, which is only temporary.

 

[nabilla]

Infections (for which you are currently taking antibiotics) and steroids are known to raise blood glucose quite spectacularly.
I wouldn't draw any conclusions to your daily BG readings until at least a week or so after your chest infection and last dose of steroids have gone, and I'd definitely not trial a libre while still fighting an infection or taking steroids. It will only show you how illness and steroids affect you, which is only temporary.

Thanks..in that case I may not mention that I'm measuring my blood glucose levels to the nurse at all just now.

 

[ajbod]

My thinking on monitoring is it's essential to know where you stand. If the health care professionals want to know figures, then it's up to them to fund it, that means i don't mention it, and should they ask then i have an argument as to why they need to fund it.

 

[Chris24Main]

@nabilla - I think you are going to find (just from what you've written so far) that quickly you will understand how all this works (for you) better than anyone else. Get yourself well first - infection requires energy to fight off, and that means more Glucose, so pretty much give yourself a pass until you're better.

Your will have a ton of information fired at you - feel free to come back and talk it through.
Good luck!!

 

[nabilla]

Thanks everyone, this forum has been so supportive and useful.
The nurse was nice. She kept referring to my lower carb diet as "extreme", but she did also tell me to Google Dr David Unwin and said all his patients had been able to go into remission from diabetes T2 or reverse prediabetes through a low carb diet, so she wasn't totally dismissive. She was concerned I'd lose weight but I said folk on this forum had already advised me that low carb doesn't equal low calorie and to keep my calories at the normal level.
I also saw the doctor and have got worse in terms of oxygen levels so more anti biotics and steroids and I've got to go now to get a chest x-ray.
Can't wait to get started in earnest. Will keep up my low carb as I recover as I enjoy it and it looks pretty healthy to me, but I'll stop BGM until I'm clear of the drugs and better for at least a week.

Thanks again all

 

[ajbod]

They tend to equate low carb, with Keto. They can't seem to grasp there is a difference. Keto is absolutely fine, but is only necessary for a small proportion of diabetics, and then only if the individuals system dictates it. It's great as a way to lose weight, but not needed for most to control their blood sugars. Any reduction is good as long as it achieves the goal of lower numbers, That dictates how low you need to go.

 

[Chris24Main]

Great to hear that you had such a positive meeting. However much some of us believe in the results we see in ourselves through low-carb high-fat, it's so much easier if you're not also fighting the system. I think we also have to keep remembering that most practicing physicians and nurses are only following the training that they've had; but great to hear that your DB had even heard of Dr David Unwin - that's a hugely positive sign...
Hope you're feeling better soon..